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‘Nothing is shut down, life & the economy go on’: Trump claims the oil price war behind markets crash is ‘GOOD for the consumer’ because gas prices are coming down and blames fake coronavirus news for historic drop
Donald Trump continues to downplay the threat of coronavirus, claiming the media and Democratic Party is trying to ‘inflame’ the situation in the U.S.
‘The Fake News Media and their partner, the Democrat Party, is doing everything … to inflame the CoronaVirus situation,’ the president tweeted Monday
He also insisted that the massive market drop Monday morning is actually ‘good for the consumer’ because prices are lower for gasoline
His claim comes as the death toll in the U.S. reached 26 Monday
Global and the U.S. stock markets also continue to plummet over the fast-spreading virus and concerns over Saudi Arabia launching a price war on oil
Trump, the first to tout market gains under his administration, has not address the market impact of coronavirus
Donald Trump claimed the oil price crash which led to the plunging stock market was ‘good’ for consumers because it is based on cheaper gas Monday as Wall Street faced a fall so dramatic trading was briefly halted.
‘Good for the consumer, gasoline prices coming down!’ Trump tweeted Monday, one of a string of tweets accusing the ‘fake news’ of prompting the sell-off.
He accused the media of ‘inflaming’ the virus outbreak and dismissed the collapse in oil prices as the result of Saudi Arabia and Russia ‘arguing.’
As the Dow Jones lost a year’s gains, he was shuttling across Florida from Mar-a-Lago to a $100,000-a-head fundraiser – and tweeting that flu was worse than coronavirus.
‘Saudi Arabia and Russia are arguing over the price and flow of oil,’ Trump continued in another tweet Monday morning. ‘That, and the Fake News, is the reason for the market drop!’
Markets all over the world plummeted Monday over the growing threat of the virus spreading, but Trump has not addressed the economic impact as the coronavirus death toll bypassed 20 in the U.S.
Global markets opened with big losses Monday morning as the economy saw its worst day in more than 10 years.
Trump continued to downplay the threat, citing that more people died from the flu last year, and insisting life and the economy will ‘go on’ even over the escalation in coronavirus outbreak.
‘So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year,’ Trump cited in a tweet.
‘Nothing is shut down, life & the economy go on,’ he insisted. ‘At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!’
The president has repeatedly expressed incredulity at the number of flu deaths, and the idea that people die of it. In 1918, his grandfather Freidrich died of Spanish flu.
Trump claims that media outlets are working with Democrats to make the coronavirus outbreak seem worse than it is.
Donald Trump claimed Monday morning that the market drop is ‘good for the consumer’ because gasoline prices are coming down
The Dow Jones saw its worst single-day drop since 2008 as Saudi Arabia goes into a price war over oil and concerns over coronavirus spreading continues to rock, but Trump said the ‘fake news’ is the reason for the plummet
During his trip to attend a fundraiser in Orlando, Trump shook hands with supporters gathered to greet him
The president insisted while tweeting from Florida Monday that ‘life & the economy [will] go on’ as markets plunged and coronavirus concerns spread
In continuing to downplay the threat of coronavirus, he claimed the media and Democratic Party are trying to ‘inflame’ the situation in the U.S.
Instead, he took to Twitter to laud himself and his administration for the response to the outbreak
Trump also praised himself for making the decision to halt travel from high-risk countries as the fast-spreading respiratory virus rose as a worldwide threat
‘The Fake News Media and their partner, the Democrat Party, is doing everything within its semi-considerable power (it used to be greater!) to inflame the CoronaVirus situation, far beyond what the facts would warrant,’ the president tweeted Monday morning.
‘Surgeon General, ‘The risk is low to the average American,” he continued, quoting U.S. Surgeon General Jerome Adams.
‘So much FAKE NEWS!’ he lamented in a separate tweet Monday morning.
Trump’s claims comes as the death toll in the U.S. reached 26 on Monday afternoon and cases continued to spread to new areas of the country, including the first confirmed case in Washington, D.C.
Kansas and Missouri also announced their first cases over the weekend as the cases number now exceeds 600.
The most U.S. deaths occurred in Washington state after the virus spread among residents at a nursing facility in a suburb of Seattle.
But Trump insists the threat is less serious than is being portrayed by media reports and Democratic lawmakers.
He then praised himself in another tweet Monday morning for banning travel from high-risk countries early on in the outbreak.
‘The BEST decision made was the toughest of them all – which saved many lives,’ Trump lauded of his administration. ‘Our VERY early decision to stop travel to and from certain parts of the world!’
Trump stopped travel from certain countries to the U.S., including from China and Iran – and Americans have been warned of traveling to other high-risk countries like Italy and South Korea.
The president is usually the first to address stock market gains under his administration, but since coronavirus has caused markets to fall, he has remained largely silent on the matter.
Earlier this month, the U.S. saw its worst week since the 2008 financial crisis and on Monday markets plunged nearly 7 per cent.
Markets in Asia, Europe and the Middle East also opened sharply lower on Monday as investors came to grips with the global spread of coronavirus.
Trump also praised Vice President Mike Pence, who he appointed last month to lead the charge by the coronavirus task force on addressing the outbreak and halting the spread
Economic experts claimed Monday morning that investors are waking up ‘shell shocked,’ as oil markets crashed.
The global market plunged, causing the worst one-day crash in crude oil prices in 30 years, after Saudi Arabia launched a price war.
On Friday Russia refused to follow OPEC’s efforts to stop market plummets caused by the escalation of the coronavirus outbreak.
In early trading, BP was down by 18 percent, Royal Dutch Shell was down 14 percent and ExxonMovil was down 11 percent.
Ordinarily, a slump in oil prices offers a boost for airlines because their fuel costs are low.
But with the ever-shrinking demand for flights due to the virus, they have been left unable to capitalize.
The coronavirus crisis, which has now infected more than 110,000 people globally, has crippled supply chains and prompted cuts to global growth forecasts for 2020.
Downtrodden brokers on the floor of the New York Stock Exchange on Monday morning before the market opened
Gregory Rowe, a trader, look forlorn as he waits for the markets to open
There are now more than 500 cases of the virus in the US alone
There is no sign that the spread is close to slowing down, either.
Traders are now expecting the Federal Reserve to again cut interest rates next week after an emergency reduction on March 3, putting the yield on benchmark 10-year U.S. Treasury on course for its biggest one-day fall in almost a decade.
Shares of rate-sensitive U.S. banks Citigroup Inc, Bank of America Corp, JPMorgan Chase & Co, Goldman Sachs, Wells Fargo & Co and Morgan Stanley slid between 7.4 percent and 9.6 percent.
Marathon Oil Corp, Devon Energy Corp, Apache Corp, Pioneer Natural Resources Co slipped between 22 percent and 28 percent and were some of the biggest losers among S&P 500 components.
At 7:12 a.m. ET, Dow e-minis were down 1,255 points, or 4.87 per cent. S&P 500 e-minis were down 145 points, or 4.89 percent and Nasdaq 100 e-minis were down 410 points, or 4.82 percent.
Much of the chaos has been sparked by the failure of a deal between OPEC Saudi Arabia and non-OPEC leader Russia.
Generally, the world’s largest oil producers agree on production rates and cuts in order to stabilize the industry.
With coronavirus slowing demand for supply, they met last week with Russia, which is not part of OPEC but is a large oil producer, to discuss cutting production.
Russia refused, setting in motion a chain of events described by analysts as a ‘worst case scenario’ that could descend into an all-out price war.
Last month, Trump appointed Vice President Mike Pence to head the task force addressing the coronavirus crisis.
‘Great job being done by the @VP and the CoronaVirus Task Force. Thank you!’ Trump tweeted Monday.
Coronavirus has infected more than 108,000 people worldwide and is throwing many countries’ economies into turmoil.
The number of confirmed cases in New York rose by 13 over the weekend, nearing the state total to 90.
New York governor Andrew Cuomo issued a declaration of emergency in the state.
But Trump claimed late Sunday night that the messaging from Cuomo is ‘political weaponization’ of the coronavirus.
‘There are no mixed messages, only political weaponization by people like you and your brother, Fredo!’ Trump insisted in his tweet, making reference to Cuomo’s brother, CNN anchor Chris Cuomo.
Graphic shows spread of Coronavirus as world cases top 110,000
HOW SAUDI ARABIA IS TRYING TO CRIPPLE RUSSIAN OIL
Saudi Arabia slashed its oil export prices over the weekend and declared a price war with Russia that sent global markets reeling and marked the sharpest decline in oil futures since 1991.
The price drop came after Russia refused to sign on with a proposal by the Organization of the Petroleum Exporting Countries (OPEC) to cut production globally as the coronavirus outbreak has slowed the demand for oil.
OPEC nations met with allies like Russia on Thursday and Friday in Vienna to reduce oil production by an additional 1.5million barrels per day to stabilize the market starting in April through the end of the year.
But Russia refused to join to agreement.
From Russia’s perspective cutting production would boost US oil producers at the expense of international competitors and lead to a loss in profits.
On Saturday, after the group failed to come to a consensus, Saudi Arabia – which runs the world’s large oil company Saudi Aramco – slashed its export oil prices to saturate the market and trigger a price war aimed at Russia.
An oil price war triggered by a falling out between Saudi Arabia and Russia is exasperating the economic chaos. Crown Prince Mohammed bin Salman (left) and Russian president Vladimir Putin (right)
Saudi Arabia slashed crude prices to Chinese customers by as much as $6 to $7 a barrel and is looking to boost output by as many as 2million barrels a day.
China is the world’s biggest oil importer and has purchased oil at cheap prices to stockpile for future use in the past.
As a result the Brent global oil benchmark fell dramatically on Sunday by 30 percent, dropping to $31.02 a barrel at its lowest.
US West Texas Intermediate crude, the other main price benchmark for oil, dropped 27% to $30 per barrel – the lowest level since February 2016.
Sunday’s decline in the oil market was the sharpest slump in 29 years since the Gulf War in 1991.
Global stock markets took hits on Sunday with the Tokyo stock market index plunging 6.2 percent, Hong Kong 3.9 percent, Sydney 6.1 percent, and Riyadh eight percent.
The failed talks marked the first break in a three-year alliance between Saudi Arabia led by Crown Prince Mohammed bin Salman and Russia’s President Vladimir Putin.
The alliance was key to competing with a surge in American oil production that turned the US into a major crude exporter for the first time in decades.
In response to the price cut Russia said its companies were free to pump as much as they could, as per Bloomberg.
‘If you are Russia, it’s worth it for you to take a three-month price hit to see if you can knock out U.S. oil exports,’ Amy Myers Jaffe, an oil and Middle East expert at the Council on Foreign Relations, said to the New York Times. ‘They might be correct for three months but the shale never gets destroyed.’
Jaffe said the disagreement between the two nations ‘signals that the relationship between Saudi Arabia and Russia is on the skids.’
Analysts speculate the actions over the weekend may have been a game between Saudi Arabia and Russia that will end when they come to a compromise.
If not, oil prices could tumble to the lowest level in five years
In a statement Tuesday morning, the trade group Airlines for America said that “false media narratives … have led to confusion and uncertainty across the country,” and argued that it’s safe to fly, saying “numerous health officials have affirmed that the risk remains low for travelers who follow CDC guidelines.”
Sen. Maria Cantwell, the top Democrat on the committee that oversees aviation, said she didn’t fly home to Washington state last weekend and doesn’t plan to in the foreseeable future.
“I have an 88-year-old mom who’s living at my house [in Washington] and she’s been ill, and I want to give her the comfort of being there. When you have elderly people you want to make sure you’re not putting them at additional risk,” she said. “And look, do I think that there can be airline travel that is safe? Yes. But if you don’t have to…”
Sen. Richard Shelby (R-Ala.), 85, noted that the doctor said “stay off of those planes as much as we can.”
“If any of you is going to Alabama Thursday night, can I get a ride?” Shelby quipped to reporters gathered around him Tuesday. “I’ll ride in the back of the truck.”
Also Tuesday, a coalition of mostly travel interests spearheaded by the U.S. Travel Association made a similar plea, noting that canceling travel and events “has a trickle-down effect that threatens to harm the U.S. economy, from locally owned hotels, restaurants, travel advisors and tour operators to the service and frontline employees who make up the backbone of the travel industry and the American economy.”
The groups’ plea comes amid fresh warnings and widespread fear around the disease, along with new figures suggesting a worsening financial situation for the airline industry.
Yesterday, the credit rating agency Moody’s downgraded the industry’s outlook from stable to negative, warning that there is an “increasing risk to demand for passenger air travel as the coronavirus expands globally.”
And today, the Global Business Travel Association reported that business travel is “slowing at an alarming rate,” finding that 13 percent of its members have canceled even domestic travel, along with high rates of canceled international business travel.
“Those are the customers that are the most profitable for airlines,” said airline analyst Henry Harteveldt.
Though airlines have yet to publicly ask for assistance from the government, the potential for some kind of stimulus has been a topic of discussion on and off Capitol Hill for days, and President Donald Trump has indicated that he favors some assistance for airlines and the cruise industry.
On Tuesday, Trump, along with Treasury Secretary Steven Mnuchin and National Economic Council Director Larry Kudlow, met with Senate Republicans at their weekly lunch to discuss potential stimulus ideas on a range of topics.
Several Republican senators said that support for the airline and cruise industries was discussed generally, but that few specifics were given.
Sen. Roger Wicker (R-Miss.) chairman of the Senate Commerce Committee, said that he had not been approached by either industry asking for aid.
Despite the fresh bad news, there is still a high level of uncertainty in the outlook for airlines and the travel industry broadly. “At this point, you cant really do forecasting because we’ve never really been in a situation quite like this before,” said Harteveldt.
And it remains true that overall, the industry is in much better shape than it was after 9/11 and in 2008, when airlines were hit hard by the recession, said Bob Mann, another airline industry analyst.
“The industry structure and company’s balance sheets individually are in far better shape,” he said. “Even the worst balance sheets are better than the average balance sheets in 2008 and 2001.”
Airlines have been taking steps to reduce their capacity, which Mann called “prudent.”
American Airlines is the latest to make that call, announcing this morning it would cut summer international flights by 10 percent and domestic flights by 7.5 percent. Delta Air Lines also said Tuesday that it is cutting international flights by 20 percent to 25 percent and domestic flights by 10 percent to 15 percent.
Keane was born in 1943 in Manhattan, New York,[1][2] the son of Elizabeth (Davis) and John Keane. He has a brother, Ronald. Keane married Theresa Doyle in 1965 and has two sons.[3] His wife died in 2016 after having Parkinson’s disease for 14 years.[4]
In 1991 Keane saved the life of David Petraeus during a live-fire exercise. According to Keane, Petraeus was shot “accidentally, standing right next to me, and I had to fight to save his life. He had a hole about the size of a quarter in his back and is gushing with blood, and we stopped the bleeding and got him on a helicopter and got him to a surgeon and so we were sort of bonded ever since that time.”[6]
Keane retired from military service in 2003.
Post military service
Following his retirement, he has served as an informal advisor to presidents and other senior officials. He served an advisory role in the management of the U.S. occupation of Iraq, as a member of the Defense Policy Board Advisory Committee. In January 2007, Keane and scholar Frederick W. Kagan released a policy paper titled “Choosing Victory: A Plan for Success in Iraq,”[7] through the American Enterprise Institute that called for bringing security by putting 30,000 additional American troops there for a period of at least 18 months. In part convinced by this paper, President George W. Bush ordered on January 10, 2007, the deployment of 21,500 additional troops to Iraq, most of whom would be deployed to Baghdad. This deployment has been nicknamed the 2007 “surge“.[8][9]
Of his initial meeting with President Bush regarding the surge, Keane said he made a phone call to Newt Gingrich to ask his advice prior to the meeting. As Keane said in 2014,
Gingrich gave me some good advice. He said, “Look, Jack. Most people go in the Oval Office, even people who go in there a lot, have a tendency in front of the President of the United States to always leave something on the table.” He said, “Don’t leave anything on the table.” He said, “You’re going to get about 15 minutes at best and put it all out there. And when you walk out of that room, feel good that you got it all out there.” So that was sound advice, and I did put it all out there.[10]
Keane was asked by then-Vice President Cheney to go back on active duty and lead the surge in the field. When Keane declined, Cheney pressed him to come work in the White House and oversee both the wars in Afghanistan and Iraq; Keane again declined. Keane ended up briefly working at the White House and then later traveled to Iraq several times to advise General Petraeus.[11]
Current activities
Keane is a regular contributor to Fox News, and is involved in a variety of business, think tank and charitable activities. He serves as chairman of AM General, the firm that produces the Humvee.[12][13]. In June 2016, Keane co-founded IP3 International (IP3), a nuclear energy consulting firm.
Keane is an advisor to the Spirit of America, a 501(c)(3) organization that supports the safety and success of Americans serving abroad and the local people and partners they seek to help.[14] He formerly served as a strategic advisor for Academi and is a former director of defense giant General Dynamics.
Shortly after Stanley A. McChrystal declined the Secretary of Defense job, Vice-President Elect Pence heard the emotional reasons for the newly widowed general’s decline of the same job. After the departure of General Mattis, the President offered the job again to the subject, but he declined because he was newly remarried.[15] He is considered an influential voice to leaders from both major political parties, including President Trump, particularly on foreign policy issues related to the Middle East.[16]
IP3
Keane is a cofounder and director of IP3 International.[17] According to a staff report to the chairman of the House Oversight Committee, during the 2016 U.S. presidential campaign of Donald Trump, and subsequently, Trump aides such as Jared Kushner and others have been engaged in promoting IP3’s plan to transfer nuclear technology from the U.S. to Saudi Arabia. According to the report, IP3 founders and others have been seeking to broker a deal with Riyadh without the “gold standard,” a provision — tied to section 123 of the 1954 Atomic Energy Act which establishes conditions for nuclear cooperation between the U.S. and its allies — that seeks to limit weaponizing of nuclear energy.[18][19] In July 2019, the committee chairman released a second staff report that detailed various activities and contacts between IP3 and the Trump administration.[18][20]
His civilian awards include the Fordham University Distinguished Alumni Award, the USO 2002 Man of the Year award, and the Association of the United States Army 2001 Man of the Year award.
^Hastings, Hirsh, and Wolffe (January 8, 2007). “‘Surge’ Strategy”. Newsweek National News. MSNBC. p. 2. Archived from the original on January 14, 2007. Retrieved January 16,2007.
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Phil Smith, MD, medical director of the Biocontainment Unit at Nebraska Medical Center and Angela Hewlett, MD, associate medical director of the unit, provide answers to some commonly asked questions about the disease – both for providers and the general public.
Questions & Answers About Ebola – Nurses – Nebraska Medicine
Biocontainment Unit nurses Kate Boulter and Morgan Shradar answer questions for providers and the public about treating patients with the Ebola virus. For more information, visit http://www.NebraskaMed.com.
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Maine Nurse Violates Cautionary Ebola Quarantine by Going for Bike Ride
US Ebola Nurse Kaci Hickox Fighting Quarantine ‘Completely Healthy’
WATCH: Kaci Hickox breaks her quarantine, gives CNN biking interview
Ebola Nurse Goes for Bike Ride – Quarantine Be Damned
Ebola Nurse Kaci Hickox Goes on Bicycle Ride
GOVERNMENT AGENCIES SCRAMBLE TO PURCHASE HAZMAT SUITS
Orders from one company surpass 1 million as concerns about Ebola linge
RELATED: Exclusive: U.S. Government Orders 250,000 Hazmat Suits to be Sent to Dallas
Government agencies across the world are rushing to snap up protective gear as concerns about the spread of the Ebola virus continue to dominate, with Lakeland Industries announcing that it has received 1 million orders for Hazmat suits alone.
Lakeland hit the headlines last month when it was revealed that the U.S. State Department had ordered 160,000 Hazmat suits from the Ronkonkoma, NY company.
The manufacturer saw its stock soar by 30% in after-hours trading on Wednesday after a press release on business activity related to Ebola revealed that the company was still being inundated with orders for Hazmat suits and other PPE items.
“Through its direct sales force and numerous distribution partners throughout the world, Lakeland has secured new orders relating to the fight against the spread of Ebola. Orders have been received from government agencies around the world as well as other public and private sector customers. Certain of these contracts require weekly delivery guarantees or shipments through the first calendar quarter of 2015. The aggregate of orders won by Lakeland that are believed to have resulted from the Ebola crisis amount to approximately 1 million suits with additional orders for other products, such as hoods, foot coverings and gloves,” states the press release.
The company adds that orders for ChemMAX and MicroMAX protective suit lines have increased 50% since August and are on course for a 100% increase by January 2015.
As Infowars reported last week, the federal government is quickly exhausting supplies for Hazmat suits in the United States, with numerous distributors being forced to place stock on hold for “government needs” only as concerns about Ebola linger after a third case was confirmed in New York.
Other federal agencies like the National Institutes of Health are also stockpiling PPE gear in anticipation of an “emergency event” disrupting the supply chain.
Lakeland, which already enjoyed a 40% stock surge in the aftermath of the first Ebola case being confirmed in the United States, is currently selling class A Hazmat suits for $1300 dollars. Business Insider’s Sam Ro accuses the company of cashing in on the spread of the Ebola virus and the fear that has come with it,” noting that the word “Ebola” is mentioned twelve times in their press release.
The U.S. public health system and primary healthcare providers must be prepared to address various biological agents, including pathogens that are rarely seen in the United States. High-priority agents include organisms that pose a risk to national security because they
can be easily disseminated or transmitted from person to person;
result in high mortality rates and have the potential for major public health impact;
might cause public panic and social disruption; and
require special action for public health preparedness.
Nurse Kaci Hickox defied Maine’s mandatory Ebola quarantine on Thursday and headed out for a bike ride with her boyfriend.
The 33-year-old nurse left her home in Fort Kent, Maine with partner Ted Wilbur this morning, wearing gloves, a safety helmet and couple of layers of fleece to combat the bitter cold.
Miss Hickox broke her quarantine at 9am and took an ATV trail behind her home for the hour-long ride. A state trooper who had been stationed outside the house followed her in a police cruiser.
‘It’s just good to be out,’ Miss Hickox told MailOnline as she left.
Maine police were monitoring her movements and public interactions but there was no court order to arrest the nurse.
Scroll down for video
Nurse Kaci Hickox went for an hour-long bike ride on Thursday morning because, she said, ‘there was nothing to stop her’
The 33-year-old nurse went on a bike ride with her partner Ted Wilbur this morning as she defied the mandatory Ebola quarantine placed on her by the state of Maine
The nurse and her boyfriend went for a bike ride on Thursday morning and were trailed by a Maine state trooper who said he was monitoring her actions but had no intention of arresting her
Miss Hickox rides past the unmarked car of a Maine state trooper who followed the nurse but said he had no intention of arresting her
Nurse Kaci Hickox left her home on a rural road in Fort Kent, Maine, to take a bike ride with her boyfriend Ted Wilbur. Police are monitoring her, but can’t detain her without a court order signed by a judge
Maine nurse defies Ebola quarantine with bike ride
As she returned home, she said: ‘There is no court action against me. There is nothing to stop me from going for a bike ride in my home town.’
I shook Ebola nurse’s hand: The moment MailOnline reporter touched quarantined Kaci Hickox
On Thursday morning I woke to find myself featured in a mini-media firestorm. Why? Because I had shaken the hand of a woman I had just interviewed.
But this wasn’t any woman – it was Kaci Hickox, 33, the nurse who is challenging her 21-day quarantine after returning from treating Ebola victims in Sierra Leone.
Stories were written of our encounter with headlines such as: ‘Nurse breaks quarantine, shakes reporter’s hand’. It was newsworthy because she should not have contact with the public.
I was one of a handful of reporters outside her home in Fort Kent, Maine, when she decided to come outside and talk about her ‘appalling’ confinement.
Under Maine’s official health guidelines she is not supposed to be in public until the three-week period is over. That is not until November 10.
The guidelines are not mandatory but are voluntary. After she made it clear that she doesn’t intend to stick to the rules – which are more stringent than those imposed by the CDC – Maine officials are preparing to secure a court order to force her to stay away from the public.
Defiant Hickox is living with her boyfriend, Ted Wilbur – who has been out and about talking to friends. And on Thursday she went for a bike ride followed by a gaggle of reporters and cameramen.
Despite a state trooper being stationed outside the house, no one tried to prevent people from getting close to her.
Wednesday night’s impromptu press conference was the first time I had been face-to-face with Hickox. Towards the end she bemoaned the fact that despite showing no symptoms of infection, she shouldn’t hug or even shake her hand of people she meets.
On the spur of the moment, I simply said: ‘I’ll shake your hand,’ and I did. It felt like a common courtesy to someone I had just been asking questions of.
It was a brief handshake, nothing memorable, something I have done thousands of times before. She had a firm grip. She looked me briefly in the eye and thanked me.
I turned to leave her property as she and Wilbur went back inside. One local Maine journalist told me he had thought about doing the same but I got there first.
Medical experts say the chances of Hickox falling ill from Ebola are now extremely remote and the risk of transmitting the virus while she is healthy are so slight as to be virtually non-existent – particularly to someone like me who touched her hand so briefly.
President Obama on Wednesday tried to reassure the public that it is safe to touch healthcare workers returning from Ebola ‘hot zones’ when he did the same and shook the hands of doctors and nurses in the 21-day risk period at the White House.
The one question I have been asked repeatedly since is: ‘Did I wash my hands afterwards?’.
Yes I did.
Hickox said that she had not spoken to her lawyers about the ride and it was her decision to go out and get exercise after a day of being cooped up in her house.
The state trooper who followed them by car said he was just monitoring Miss Hickox’s actions and had no intention of arresting her.
The nurse did not say whether she would venture outside again on Thursday, adding that she had to return home to prepare for her daily temperature check for Ebola symptoms from the state’s Center for Disease Control.
Hickox contends there is no need for quarantine because she’s showing no symptoms.
She’s also tested negative for the deadly disease.
Maine Governor Paul LePage told ABC on Thursday that he would give up on the state’s demand to keep the nurse under quarantine if she agrees to take a blood test.
Lawyers for the state of Maine went to court today to ask a judge to order Hickox to take a blood test.
LePage told ABC: ‘This could be resolved today. She has been exposed and she’s not cooperative, so force her to take a test. It’s so simple.’
However, according to Ebola experts, a blood test for Ebola would only be positive if Hickox was displaying symptoms of the virus – which she says she is not.
The Ebola virus is only detectable in the blood if the disease has significantly progressed.
Miss Hickcox has not made it clear whether she would or would not be agree to taking a blood test.
LePage later added that the nurse was causing a lot of tension and worry in the community of Fort Kent.
‘I don’t want her within three feet of anyone,’ LePage told NBC.
On Wednesday night, Miss Hickox left the home she has been ordered to stay inside for 21 days in order to speak with the press about her ‘frustrating’ situation.
Standing in front of her boyfriend’s house, as the police tasked with watching her looked on from across the street, Miss Hickox told the waiting media contingent that she will continue to fight her quarantine orders, even if she is charged for breaking them.
‘We have been in negotiations all day with the state of Maine and tried to resolve this amicably, but they are not allowing me to leave my house and interact with the public even though I am completely healthy and symptom free,’ Miss Hickox said, according to The Press Herald.
‘I am frustrated by this fact, and I have been told that it is the Attorney General’s intention to file legal action against me. And if this does occur, I will challenge the legal actions.’
Hickox shook the hand of MailOnline’s reporter at the scene and said: ‘You could hug me. You could shake my hand. I would not give you Ebola’.
The Doctors Without Borders nurse believes she flew into New Jersey from treating dying Ebola patients in West Africa on ‘the wrong day’.
She claimed that many other aid workers have entered the country and continue to do so without having to go through what she had.
Hickox said she remains healthy and has not shown any Ebola symptoms and that the measures she’s being forced to comply with are over-the-top.
However residents of Fort Kent, a small rural, logging community, where she is staying have said that ’21 days (of quarantine) is better is better than 21 deaths’ and that it is a necessary precaution.
‘I’m upset that Chris Christie ever let her go from New Jersey,’ said resident Anne Dugal. ‘He should have kept her there longer.
‘She says she only had a temperature of 101 because she got upset. No-one shows a temperature because they’re upset. She should stay inside.’
Ted Wilbur, Miss Hickox’s boyfriend, had walked over to the police parked across the street from their house on Wednesday to check Hickox would not be arrested for leaving the house.
She did not go any further than the driveway and police remained across the street for the press conference.
MailOnline reporter Martin Gould (pictured right) shakes the hand of nurse Kaci Hickox (left) outside her home in Fort Kent, Maine on Wednesday after she stepped outside to defy the state’s Ebola quarantine
Nurse Kaci Hickox (left) and her boyfriend Ted Wilbur speak to the media on Wednesday. MailOnline reporter Martin Gould (center) shook Miss Hickox’s hand following the impromptu press conference
The nurse made a point of going out on an early morning bike ride on Thursday after describing the decision to keep her under quarantine in Maine as ‘appalling’
Miss Hickox returned to her home on Thursday morning trailed by reporters after she made the decision to break her Ebola quarantine
‘Don’t bully me’ Maine nurse who refuses to be quarantined
Hickox said she remains healthy and has not shown any Ebola symptoms and that the measures she’s being forced to comply with are over-the-top.
However residents of Fort Kent, a small rural, logging community, where she is staying have said that ’21 days (of quarantine) is better is better than 21 deaths’ and that it is a necessary precaution.
‘I’m upset that Chris Christie ever let her go from New Jersey,’ said resident Anne Dugal. ‘He should have kept her there longer.
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‘She says she only had a temperature of 101 because she got upset. No-one shows a temperature because they’re upset. She should stay inside.’
Ted Wilbur, Miss Hickox’s boyfriend, had walked over to the police parked across the street from their house on Wednesday to check Hickox would not be arrested for leaving the house.
She did not go any further than the driveway and police remained across the street for the press conference.
Defiant: Kaci Hickox and her boyfriend Ted Wilbur held a press conference outside their Fort Kent, Maine, home at 7pm on Wednesday night, despite orders by the state to stay indoors
State police troopers were stationed outside the Fort Kent, Maine, home of Kaci Hickox on Wednesday after she threatened to break Maine quarantine guidelines – however they are voluntary at the moment so it is unclear whether they would have the authority to arrest her without a court order
Attacks on Hickox have come thick and fast after she told both NBC’s ‘Today’ show and ABC’s ‘Good Morning America’ that she planned to stay in her home on the outskirts of Fort Kent only for one day after being driven back from New Jersey.
Maine Governor Paul LePage stationed state troopers outside the house that Hickox, 33, shares with her boyfriend Ted Wilbur, setting the stage for a showdown should she decide to leave.
The governor’s office did not say whether the nurse would be arrested if she tried to leave, but said state police were stationed outside the home ‘for both her protection and the health of the community’.
The state’s guidelines are voluntary but Governor LePage wants to make it mandatory and enforceable with a court order.
State Health Commissioner Mary Mayhew told reporters in the capital Augusta: ‘When it is made clear by an individual in this risk category that they do not intend to voluntarily stay at home for the remaining 21 days, we will immediately seek a court order.’
According to NBC the hearing is not likely to be held until Monday – the day before LePage faces re-election and four days after Hickox has vowed to leave her home.
‘If I saw her in the street I wouldn’t go near her,’ said Dugal. ‘Twenty one days is not that long a time.’
Novelist Cathie Pelletier, sitting at the next table to Dugal, agreed. ‘It’s not a case that she can say sorry if she is wrong and dozens of people get infected,’ she said. ‘I can’t understand why she can’t just stay at home those extra few days.’
But both the town’s chief of police, Tom Pelletier — Cathie’s third cousin — and Dr. Michael Sullivan, the chief medical officer at Fort Kent’s hospital the Northern Maine Medical Center, said they wanted to shake Hickox’s hand and thank her for the work she has been doing helping the sick.
The conflicting views go to the heart of the confusion surrounding the approach taken by the federal government, the CDC, and individual states to the Ebola crisis and quarantine rules.
They came as many took to Facebook to slam Hickox for refusing to lock herself away for three weeks – and at the medical center where panicked patients are canceling appointments – even though Hickox has gone nowhere near it, the hospital’s boss said.
Hickox and Wilbur returned to their three-bedroom home on the outskirts of Fort Kent under cover of darkness on Tuesday night after a stopover at his uncle’s house in Freeport, Maine.
‘Twenty one days is better than 21 deaths,’ said Anne Dugal (left) as she ate lunch with her mother Dolores in the Swamp Buck Restaurant in Fort Kent on Wednesday. Novelist Cathie Pelletier (right) said: ‘It’s not a case that she can say sorry if she is wrong and dozens of people get infected’
They had driven nearly 500 miles from Newark, New Jersey where she had been held in quarantine following her arrival in the U.S. from Africa.
Hickox, 33, had been treating Ebola sufferers in Sierra Leone with the medical charity Doctors Without Borders.
She has shown no signs of the disease but a forehead thermometer showed she had a slight temperature when she arrived at Newark Liberty International airport, which she has put down to being flustered or a faulty thermometer.
I don’t plan on sticking to the (Maine’s) guidelines. I am not going to sit around and be bullied by politicians and forced to stay in my home when I am not a risk to the American public
– Kaci Hickox
Governor Chris Christie departed from national policy and had tried to confine her to a tent inside a hospital for 21 days.
But after she threatened legal action and the White House intervened, she was allowed to travel on the understanding that she would put herself in voluntary isolation in accordance with Maine state guidelines.
Hickox has since declared that she will not be bullied by ‘appalling’ confinement rules and plans to fight for her freedom if restrictions are not lifted by Maine officials on Thursday.
Hickox has said she would abide by all the self-monitoring requirements of the Centers for Disease Control and Prevention. This does not stop people from traveling outside their home, but instead advises them not to go to large gatherings. It also calls on them to take a series of tests twice a day to monitor whether they are developing symptoms.
Doctors insist that the virus is not contagious until symptoms develop.
On Wednesday morning, Hickox, 33, told Today: ‘I don’t plan on sticking to the (Maine’s) guidelines. I am not going to sit around and be bullied by politicians and forced to stay in my home when I am not a risk to the American public.’
Length of Time in U.S., Family Ties to Others in Country Are Expected Criteria
The Obama administration is considering how to decide which illegal immigrants would receive protections, such as those from deportation. WSJ’s Laura Meckler reports. Photo: Getty
By LAURA MECKLER
WASHINGTON—The White House is considering two central requirements in deciding which of the nation’s 11 million illegal immigrants would gain protections through an expected executive action: a minimum length of time in the U.S., and a person’s family ties to others in the country, said people familiar with the administration’s thinking.
Those requirements, depending on how broadly they are drawn, could offer protection to between one million and four million people in the country illegally.
The deliberations follow President Barack Obama ’s promise to act to change the immigration system, after legislation overhauling immigration law died in Congress.
Republicans have protested that Mr. Obama would overstep his authority by acting alone. Several Democratic candidates in tight races also have complained, and last month the president canceled plans to announce the changes before the election.
Mr. Obama, who has been criticized by immigrant-rights advocates for the delay, wants to grant new protections—such as safe harbor from deportation and work permits—to many people who are in the U.S. illegally but have significant ties to the country, said three people familiar with White House thinking.
Such protections would be temporary since the president lacks authority to give people permanent legal status.
ENLARGE
Demonstrators protest President Obama’s immigration policies in Washington earlier this month. AGENCE FRANCE-PRESSE/GETTY IMAGES
One person said officials are leaning toward granting protections to people in the country illegally for 10 years and who meet other criteria, though that could be broadened to include more recent arrivals.
Parents of U.S. citizens are likely to qualify, people familiar with discussions said, as long as they meet other criteria. But it is unclear whether the policy would include parents of so-called Dreamers—people brought to the U.S. illegally as children, and who were given a temporary legal status in 2012.
Also unclear is whether other family ties, such as being married to a U.S. citizen, would qualify somebody for new protections. Illegal immigrants cannot win legal status by marriage unless they return to their home country for a period of years.
The answers to those questions will determine whether up to four million people or as few as just over one million gain protections, according to estimates prepared by the nonpartisan Migration Policy Institute, which the White House has consulted.
White House spokeswoman Katherine Vargas said the president hasn’t made a decision or even received recommendations from his cabinet secretaries. “It is premature to speculate about the specific details,” she said. Still, a mid-December announcement of the change is expected by many immigration experts.
Rep. Mario Diaz-Balart (R., Fla.), who tried to move immigration legislation through the House this year, said executive action would amplify distrust among Republicans in Mr. Obama and make legislating harder. “The right’s going to fly off the rails,” he said. “How do you trust someone who says he does not have the legal authority to do something and then does it anyway?” Mr. Obama previously said that his ability to change immigration law on his own was limited.
White House officials also are considering allowing more young people into the 2012 “Dreamer’’ program that grants temporary legal status and work permits to those who were brought to the U.S. illegally as children, according to two people familiar with discussions. Some 580,000 people were enrolled in the program as of June.
No matter how the White House draws the criteria, the number gaining new protections is certain to be less than the eight million or so who would have benefited from legislation that the Senate passed last year, but that died amid GOP opposition in the House.
Any package along these lines is sure to be attacked by Republicans and possibly some Democrats as presidential overreach. Administration officials say they are working to make sure that whatever they do is legally and politically defensible.
One person people familiar with the process said the White House is trying to craft a plan that survives Mr. Obama’s presidency and isn’t so unpopular that a future Republican president could easily reverse it. “It has to be politically sustainable,” this person said.
One of the most politically sensitive questions is whether to include parents of young people in the Dreamer program, known formally as Deferred Action for Childhood Arrivals. These people are among the most politically active in the immigration debate and are demanding that their parents not be left out.
The president “must be inclusive, and he must be broad, to protect as many people as possible,” said Cristina Jimenez, managing director of the group United We Dream. “Any package of administrative reform must include our parents.”
Republicans have said that broad executive action would kill any chance for immigration legislation next year. Democrats reply that chances already are low that the two parties could come to agreement on a bill. Immigration activists are pressing Mr. Obama to take the most sweeping action possible.
The White House also is expected to change criteria used in deciding who is a priority for deportation. It may, for instance, say a traffic violation doesn’t make someone a priority, though other convictions do. The legal rationale is that the administration lacks the capacity to deport all illegal immigrants and has discretion to set priorities.
Other changes are expected to benefit businesses that use large numbers of legal immigrants, such as technology companies. One change under consideration would “recapture” unused visas from previous years in order to make more visas available to such companies, according to one person familiar with the deliberations. This person said that a second change that companies have requested—changing the way visas are counted so that a family unit counts as only one spot toward the limit—is less likely.
This person said the administration is also considering a change that would make it easier for foreign students to stay in the U.S. after graduation while they await employment-based visas.
White House officials are inclined to wait to announce the new policy until after a must-pass spending bill has cleared Congress, to avoid tangling that legislation with any GOP effort to roll back the immigration policy.
Further, the Louisiana Senate race may not be decided until a Dec. 6 runoff, and White House officials want to avoid injecting immigration into any re-election fight by Sen. Mary Landrieu , a Democrat.
It also is possible that the Georgia Senate race will remain unsolved until an early January runoff, but a senior administration official said there is no thought to pushing the announcement into next year. Mr. Obama has repeatedly vowed to act by year’s end.
Story 1: State Department Considers Importing Ebola Patients From Other Countries At A Cost Exceeding $500,000 Per Patient — Keep Infected Ebola Aliens, Legal and Illegal, Out of The United States — People’s Common Sense Vs. Elitist Arrogant Nonsense — When will America Be Ebola and Obama Free — Friday, 20 January 2017, Noon in Washington DC — Videos
Ebola death toll reaches 5,000: actual figure could be triple this, WHO reports
Nigeria declared Ebola-free – Global preparedness at peak
WHO Declares Nigeria Free Of Ebola Virus Disease
How is the end of an Ebola outbreak decided and declared?
Information note – October 2014
Who decides the date?
The WHO Ebola outbreak response team is responsible for establishing the date of the end of the outbreak in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory.
How is the date determined?
An Ebola virus disease outbreak in a country can be declared over once 42 days have passed and no new cases have been detected. The 42 days represents twice the maximum incubation period for Ebola (21 days). This 42-day period starts from the last day that any person in the country had contact with a confirmed or probable Ebola case.
This includes health care workers who have been exposed to patients with Ebola virus disease, even if the health worker was wearing personal protective equipment and followed infection control procedures since such a person could be exposed accidentally without realizing it. In the setting of an Ebola treatment centre, the date of the last infectious contact is defined as the day when the last patient in the treatment centre tested negative for Ebola virus disease, using a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test.
If no new case has been detected at the end of this 42-day period, the risk of a further case is very low, and the outbreak is declared over.
Why 42 days?
The maximum incubation period for Ebola virus disease is 21 days. The 42-day period set by WHO (twice the maximum incubation period) provides a margin of security to cover any possible missed cases, uncertainty in reporting dates or hidden chains of transmission. (*)
During the 42-day period, the surveillance system should be fully functional, so that all contacts of the last patient are followed to detect possible chains of transmission.
What is the procedure to make the declaration?
The WHO Ebola outbreak response team in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory determines the date of the end of the epidemic. The government of the affected country, in collaboration with WHO and international partners, makes an official declaration of the end of the epidemic.
Are the Ebola outbreaks in Nigeria and Senegal over?
Ebola situation assessment – 14 October 2014
Not quite yet.
If the active surveillance for new cases that is currently in place continues, and no new cases are detected, WHO will declare the end of the outbreak of Ebola virus disease in Senegal on Friday 17 October. Likewise, Nigeria is expected to have passed through the requisite 42 days, with active surveillance for new cases in place and none detected, on Monday 20 October.
For Nigeria, WHO confirms that tracing of people known to have contact with an Ebola patient reached 100% in Lagos and 98% in Port Harcourt. In a piece of world-class epidemiological detective work, all confirmed cases in Nigeria were eventually linked back to the Liberian air traveller who introduced the virus into the country on 20 July.
The anticipated declaration by WHO that the outbreaks in these 2 countries are over will give the world some welcome news in an epidemic that elsewhere remains out of control in 3 West African nations.
In Guinea, Liberia, and Sierra Leone, new cases continue to explode in areas that looked like they were coming under control. An unusual characteristic of this epidemic is a persistent cyclical pattern of gradual dips in the number of new cases, followed by sudden flare-ups. WHO epidemiologists see no signs that the outbreaks in any of these 3 countries are coming under control.
How does WHO declare the end of an Ebola outbreak?
A WHO subcommittee on surveillance, epidemiology, and laboratory testing is responsible for establishing the date of the end of an Ebola outbreak.
The date is fixed according to rigorous epidemiological criteria based on the last day that any person in the country had contact with a confirmed or probable Ebola case.*
According to WHO recommendations, health care workers who have attended patients or cleaned their rooms should be considered as “close contacts” and monitored for 21 days after the last exposure, even if their contact with a patient occurred when they were fully protected by wearing personal protective equipment.
For health care workers, the date of the “last infectious contact” is the day when the last patient in a health facility tests negative using a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test.
For WHO to declare an Ebola outbreak over, a country must pass through 42 days, with active surveillance demonstrably in place, supported by good diagnostic capacity, and with no new cases detected. Active surveillance is essential to detect chains of transmission that might otherwise remain hidden.
Incubation period
The period of 42 days, with active case-finding in place, is twice the maximum incubation period for Ebola virus disease and is considered by WHO as sufficient to generate confidence in a declaration that an Ebola outbreak has ended.
Recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42 day interval. WHO is therefore confident that detection of no new cases, with active surveillance in place, throughout this 42-day period means that an Ebola outbreak is indeed over.
The announcement that the outbreaks are over, in line with the dates fixed by the subcommittee on surveillance, epidemiology, and laboratory testing, is made by the governments of the affected countries in close collaboration with WHO and its international partners.
Official announcements for the 2 countries will be made on the WHO website.
WHO recommendations for testing for Ebola virus disease and confirming a case
WHO is alarmed by media reports of suspected Ebola cases imported into new countries that are said, by government officials or ministries of health, to be discarded as “negative” within hours after the suspected case enters the country.
Such rapid determination of infection status is impossible, casting grave doubts on some of the official information that is being communicated to the public and the media.
For early detection of Ebola virus in suspected or probable cases, detection of viral ribonucleic acid (RNA) or viral antigen are the recommended tests.
Laboratory-confirmed cases must test positive for the presence of the Ebola virus, either by detection of viral RNA by RT-PCR, and/or by detection of Ebola antigen by a specific Antigen detection test, and/or by detection of immunoglobulin M (IgM) antibodies directed against Ebola.
Two negative RT-PCR test results, at least 48 hours apart, are required for a clinically asymptomatic patient to be discharged from hospital, or for a suspected Ebola case to be discarded as testing negative for the virus.
Laboratory results should be communicated to WHO as quickly as possible, in addition to reporting under the requirements and within the timelines set out in the International Health Regulations, which are administered by WHO.
Note
WHO recommends that the first 25 positive cases and 50 negative specimens detected by a country without a recognized national reference viral haemorrhagic fever laboratory should be sent for secondary confirmatory testing to a WHO collaborating centre, designed as specialized in the safe detection (at biosafety level IV) of viral haemorrhagic fevers.
Similarly, for countries with a national reference laboratory for viral haemorrhagic fevers, the initial positive cases should also be sent to a WHO collaborating centre for confirmation.
If results are concordant, laboratory results reported from the national reference laboratory would be accepted by WHO.
President Obama is doing reasonably well on this whole Ebola thing — at least on the public relations front — but another new poll suggests Americans want him to take actions that he has resisted so far.
The poll, from CBS News, shows a whopping 80 percent of people want American citizens and legal residents returning from West Africa to be quarantined until it is determined that they are Ebola-free. Another 17 percent think they should be allowed to enter the country if they are symptom-free at the time.
The poll, notably, did not specify just how long such people would need to be quarantined — about 21 days — or where they would be quarantined. (Such specifics could conceivably reduce support.)
The poll echoes a Washington Post-ABC News poll from earlier this week that showed support for restricting entry from those same countries at 70 percent.
The White House struck a defiant tone on this issue on Wednesday, with Obama saying, “We don’t just react based on our fears. We react based on facts and judgment and making smart decisions.”
That seemed a clear — if indirect — shot at governors of both parties who have instituted quarantines in their states. One of them, New Jersey Gov. Chris Christie (R), released an American nurse from quarantine after the nurse publicly fought against it. The nurse, Kaci Hickox, had returned from treating Ebola patients in Sierra Leone, and Christie said she was ill and they needed to rule out Ebola. She has since reportedly said she will not abide by the government’s quarantine in her home state of Maine.
The White House has stressed repeatedly that such travel restrictions and quarantines would be counter-productive, especially by discouraging medical professionals from traveling to West Africa to fight the disease at its source.
Do Americans believe there should be a quarantine to deal with Ebola?
By Sarah Dutton, Jennifer De Pinto, Anthony Salvanto and Fred Backus
A new CBS News poll finds that Americans overwhelmingly support quarantine for travelers arriving from West Africa. Eighty percent think U.S. citizens and legal residents returning from West Africa should be quarantined upon their arrival in the U.S. until it is certain they don’t have Ebola. Just 17 percent think they should be allowed to enter as long as they do not show symptoms of Ebola.
Polling began on the evening of Oct. 23, the night Dr. Craig Spencer became the first U.S. citizen to be diagnosed with Ebola inside the United States after contracting the disease in West Africa.
Americans are even more stringent when it comes to foreign visitors from West Africa. Just 14 percent think foreign visitors should be allowed to enter the U.S. as long as they show no symptoms of Ebola. Most–56 percent–think they should be quarantined upon arrival, while just over a quarter (27 percent) don’t think they should be allowed to enter the U.S. at all until the Ebola epidemic in West Africa is over.
Americans continue to show concern that the federal government is not adequately prepared to deal with an outbreak of Ebola in the United States. Fifty-six percent do not think the federal government is adequately prepared, and 66 percent feel the same way about their own local hospital.
Sixty-one percent of Americans are at least somewhat concerned that there will be a large outbreak of Ebola inside the United States within the next twelve months. Still, the percentage of Americans who are very concerned has dropped eight points, from 40 percent at the beginning of the month to 32 percent now.
And few Americans believe they or their family are directly at risk. Eighty-three percent of Americans don’t think it is likely that they or a member of their family will get Ebola, including 52 percent who say it is not likely at all.
This poll was conducted by telephone October 23-27, 2014 among 1,269 adults nationwide. The error due to sampling for results based on the entire sample could be plus or minus three percentage points. The error for subgroups may be higher. Data collection was conducted on behalf of CBS News by SSRS of Media, PA. Phone numbers were dialed from samples of both standard land-line and cell phones. Interviews were conducted in English and Spanish. This poll release conforms to the Standards of Disclosure of the National Council on Public Polls.
State Department plans to bring foreign Ebola patients to U.S.
The State Department has quietly made plans to bring Ebola-infected doctors and medical aides to the U.S. for treatment, according to an internal department document that argued the only way to get other countries to send medical teams to West Africa is to promise that the U.S. will be the world’s medical backstop.
Some countries “are implicitly or explicitly waiting for medevac assurances” before they will agree to send their own medical teams to join U.S. and U.N. aid workers on the ground, the State Department argues in the undated four-page memo, which was reviewed by The Washington Times.
“The United States needs to show leadership and act as we are asking others to act by admitting certain non-citizens into the country for medical treatment for Ebola Virus Disease (EVD) during the Ebola crisis,” says the four-page memo, which lists as its author Robert Sorenson, deputy director of the office of international health and biodefense.
More than 10,000 people have become infected with Ebola in Liberia, Sierra Leone and Guinea, and the U.S. has taken a lead role in arguing that the outbreak must be stopped in West Africa. President Obama has committed thousands of U.S. troops and has deployed American medical personnel, but other countries have been slow to follow.
In the memo, officials say their preference is for patients go to Europe, but there are some cases in which the U.S. is “the logical treatment destination for non-citizens.”
The document has been shared with Congress, where lawmakers already are nervous about the administration’s handling of the Ebola outbreak. The memo even details the expected price per patient, with transportation costs at $200,000 and treatment at $300,000.
Nurse Kaci Hickox says she won’t obey Maine’s Ebola quarantine: I won’t be ‘bullied by politicians’
Eun Kyung
Nurse Kaci Hickox — who remains symptom-free after spending three days in a New Jersey isolation tent after flying home from Ebola-stricken West Africa — remains under quarantine at home in Maine, but for only another day, she tells TODAY’s Matt Lauer.
“I truly believe this policy is not scientifically nor constitutionally just, and so I’m not going to sit around and be bullied around by politicians and be forced to stay in my home when I am not a risk to the American public.”
Hickox, who pointed out that top health officials believe a quarantine is unnecessary unless someone develops symptoms, also said:
She will pursue legal action if Maine forces her into continued isolation: “If the restrictions placed on me by the state of Maine are not lifted by Thursday morning, I will go to court to fight for my freedom.”
She plans to return to Africa to help Ebola patients: “My work in Sierra Leone for four weeks was amazing and I feel privileged to have been able to fight this battle and I do plan on going back. It’s not just will I, it’s more of a when.”
State officials should maintain health guidelines but New Jersey officials demonstrated a lack of scientific rationale: Hickox said policies need to be based on evidence, but what she saw at Newark airport showed no such basis. “I saw complete disorganization. I saw no leadership, and if you’re going to put a policy like that in place, that impedes on my civil rights, then you need to have the administrative details worked out before you start detaining me in an airport for no reason.”
Maine Governor Seeks to Make Nurse Abide by Quarantine
By Michelle Kaske
Governor Paul LePage said he would try to force nurse Kaci Hickox to abide by Maine’s Ebola quarantine, escalating the confrontation between the previously little-known aid worker and the political leaders of two states.
Hickox, who has shown no symptoms since a brief fever, was kept in a tent at a New Jersey hospital after returning from treating patients in Sierra Leonebefore being released by Governor Chris Christie. She said today she wouldn’t follow isolation orders in Maine, where she lives. LePage, a 66-year-old Republican facing a re-election fight Nov. 4, said he would try to make her.
“Upon learning the healthcare worker intends to defy the protocols, the Office of the Governor has been working collaboratively with the State health officials within the Department of Health and Human Services to seek legal authority to enforce the quarantine,” he said a statement. “While we certainly respect the rights of one individual, we must be vigilant in protecting 1.3 million Mainers.”
Government officials are struggling to calm fears of contagion while not penalizing aid workers who venture to countries at the center of the still-raging epidemic. In West Africa, the virus has infected about 10,000 people and killed about half, according to the World Health Organization. In the U.S., one man who traveled from Liberia died.
Nurse’s Revolt
Hickox, a 33-year-old volunteer for Doctors Without Borders, said this morning that Maine’s orders were unjust.
“I remain appalled by these home quarantine policies that have been forced upon me, even though I am in perfectly good health and feeling strong and have been this entire time completely symptom free,” Hickox said today in an interview on NBC’s “Today” show.
If the state were to force Hickox to stay home through a court order, she would fight such a move, said Steven Hyman, one of her lawyers.
“If they attempt to get one, Kaci will contest it,” Hyman, a partner in New York at McLaughlin & Stern LLP, said in a telephone interview.
Doctors Without Borders “strongly disagrees with blanket forced quarantine for health care workers returning from Ebola affected countries,” the group said in an e-mailed statement.
Tent Escape
Hickox, who Oct. 26 criticized Christie for her detention, is staying in Fort Kent near the Canadian border. She wouldn’t have emerged from Maine’s 21-day quarantine until Nov. 10.
Hickox was detained for Ebola monitoring at Newark Liberty International Airport after returning from Africa. The nurse was taken to University Hospital in Newark on Oct. 24. She said the fever she registered upon arrival was due to anger.
Christie later allowed her to travel to Maine after she remained asymptomatic.
“I could care less that she hired a lawyer,” Christie said today at a press event in Little Ferry. “I hope that for the public good and for her own good that she decides to comply with the quarantine that they’ve requested in Maine. I think that’s fair to the public and it’s common sense.”
Her home, population 4,090, marks the beginning of 2,328-mile (3,746 kilometer) U.S. Route 1. Fort Kent is at the top of the state’s the northernmost county, Aroostook, across the St. John River fromCanada.
NURSE WHO TREATED EBOLA PATIENTS IN WEST AFRICA RETURNS TO TEXAS, WILL SELF-QUARANTINE
Early Wednesday morning, a nurse who had been treating Ebola patients in Sierra Leone returned to her home in Texas. The nurse, whose name is being withheld for privacy reasons, showed no signs of the disease, but CDC protocols placed her at “some” risk due to her contact with the patients. She has agreed to voluntarily self-quarantine at her home while she waits for the Ebola incubation period to pass.
Texas Governor Rick Perry’s office released a statement Wednesday calling the nurse a “health care hero,” and mentioning that Perry had spoken to her on the phone after her flight landed “to personally thank her for her heroic and selfless work on the front lines of fighting Ebola.”
“In Texas, we have a great tradition of welcoming our heroes back home and this heroic individual deserves our appreciation, our compassion, and our utmost respect,” added Perry. “The tremendous work that she and so many other health care workers are doing in West Africa is making life better for those in afflicted countries and helps protect the rest of the world from the spread of this terrible disease; they are doing vitally important work that makes us all proud.”
The nurse arrived at Austin-Bergstrom Airport, where she was greeted by Dr. David Lakey, the Commissioner of the Texas Department of State Health Services (DSHS) and a member of the Texas Task Force on Infectious Disease Preparedness and Response, which was formed earlier this month by Perry to address the Ebola crisis in Texas. The task force’s initial recommendations included better screening processes for health care workers who may have been exposed to Ebola and taking swift action to isolate such people until they can be sure they have a clean bill of health. Accordingly, at Perry’s request, the nurse agreed to self-quarantine at home, where DSHS will monitor her for fever and other symptoms of Ebola twice a day.
The nurse’s willingness to comply with the Governor’s self-quarantine request stands in sharp contrast to the situation regarding nurse Kaci Hickox, who was ordered into quarantine by New Jersey Governor Chris Christie, and, instead of complying, hired an attorney to fight the order, claiming that her “basic human rights have been violated.” Christie backed down and Hickox returned to her home in Maine, issuing a statement through her attorney that she will not agree to stay confined in her house more than two days.
Perry had additional words of praise for the Texas nurse’s decision to agree to the quarantine request. “This health care hero has made a great sacrifice in traveling abroad to minister to those who are suffering,” he said. “Even now home in Texas, she continues to demonstrate her selflessness by agreeing to quarantine herself and further protect her fellow Texans.”
Ebola virus disease
Fact sheet N°103
Updated September 2014
Key facts
Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.
The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.
The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.
The first EVD outbreaks occurred in remote villages in Central Africa, near tropical rainforests, but the most recent outbreak in west Africa has involved major urban as well as rural areas.
Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation.
Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralise the virus but a range of blood, immunological and drug therapies are under development.
There are currently no licensed Ebola vaccines but 2 potential candidates are undergoing evaluation.
Background
The Ebola virus causes an acute, serious illness which is often fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in 2 simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name.
The current outbreak in west Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (1 traveller only) to Nigeria, and by land (1 traveller) to Senegal.
The most severely affected countries, Guinea, Sierra Leone and Liberia have very weak health systems, lacking human and infrastructural resources, having only recently emerged from long periods of conflict and instability. On August 8, the WHO Director-General declared this outbreak a Public Health Emergency of International Concern.
A separate, unrelated Ebola outbreak began in Boende, Equateur, an isolated part of the Democratic Republic of Congo.
The virus family Filoviridae includes 3 genera: Cuevavirus, Marburgvirus, and Ebolavirus. There are 5 species that have been identified: Zaire, Bundibugyo, Sudan, Reston and Taï Forest. The first 3, Bundibugyo ebolavirus, Zaire ebolavirus, and Sudan ebolavirus have been associated with large outbreaks in Africa. The virus causing the 2014 west African outbreak belongs to the Zaire species.
Transmission
It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.
Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.
Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.
Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola.
People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.
Symptoms of Ebola virus disease
The incubation period, that is, the time interval from infection with the virus to onset of symptoms is 2 to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.
Diagnosis
It can be difficult to distinguish EVD from other infectious diseases such as malaria, typhoid fever and meningitis. Confirmation that symptoms are caused by Ebola virus infection are made using the following investigations:
Samples from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions.
Treatment and vaccines
Supportive care-rehydration with oral or intravenous fluids- and treatment of specific symptoms, improves survival. There is as yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated. No licensed vaccines are available yet, but 2 potential vaccines are undergoing human safety testing.
Prevention and control
Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation. Community engagement is key to successfully controlling outbreaks. Raising awareness of risk factors for Ebola infection and protective measures that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors:
Reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat. Animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption.
Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids. Gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.
Outbreak containment measures including prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola, monitoring the health of contacts for 21 days, the importance of separating the healthy from the sick to prevent further spread, the importance of good hygiene and maintaining a clean environment.
Controlling infection in health-care settings:
Health-care workers should always take standard precautions when caring for patients, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials), safe injection practices and safe burial practices.
Health-care workers caring for patients with suspected or confirmed Ebola virus should apply extra infection control measures to prevent contact with the patient’s blood and body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 metre) of patients with EBV, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).
Laboratory workers are also at risk. Samples taken from humans and animals for investigation of Ebola infection should be handled by trained staff and processed in suitably equipped laboratories.
WHO response
WHO aims to prevent Ebola outbreaks by maintaining surveillance for Ebola virus disease and supporting at-risk countries to developed preparedness plans. The document provides overall guidance for control of Ebola and Marburg virus outbreaks:
When an outbreak is detected WHO responds by supporting surveillance, community engagement, case management, laboratory services, contact tracing, infection control, logistical support and training and assistance with safe burial practices.
WHO has developed detailed advice on Ebola infection prevention and control:
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People can be infected with dangerous diseases in a number of ways. Some germs, like those causing malaria, are passed to humans by animals. Other germs, like those that cause botulism, are carried to people by contaminated food or water. Still others, like the ones causing measles, are passed directly from person to person. These diseases are called “contagious”.
Contagious diseases that pose a health risk to people have always existed. While the spread of many of these diseases has been controlled through vaccination and other public health efforts, avian influenza (“bird flu”) and terrorist acts worldwide have raised concerns about the possibility of a disease risk. That makes it important for people to understand what can and would be done to protect the public from the spread of dangerous contagious diseases.
The CDC applies the term “quarantine” to more than just people. It also refers to any situation in which a building, conveyance, cargo, or animal might be thought to have been exposed to a dangerous contagious disease agent and is closed off or kept apart from others to prevent disease spread.
The Centers for Disease Control and Prevention (CDC) is the U.S. government agency responsible for identifying, tracking, and controlling the spread of disease. With the help of the CDC, state and local health departments have created emergency preparedness and response plans. In addition to early detection, rapid diagnosis, and treatment with antibiotics or antivirals, these plans use two main traditional strategies —quarantine and isolation— to contain the spread of illness. These are common health care practices to control the spread of a contagious disease by limiting people’s exposure to it.
The difference between quarantine and isolation can be summed up like this:
Isolation applies to persons who are known to be ill with a contagious disease.
Quarantine applies to those who have been exposed to a contagious disease but who may or may not become ill.
Definitions
Infectious disease: a disease caused by a microorganism and therefore potentially infinitely transferable to new individuals. May or may not be communicable. Example of non communicable is disease caused by toxins from food poisoning or infection caused by toxins in the environment, such as tetanus.
Communicable disease: an infectious disease that is contagious and which can be transmitted from one source to another by infectious bacteria or viral organisms.
Contagious disease: a very communicable disease capable of spreading rapidly from one person to another by contact or close proximity.
When someone is known to be ill with a contagious disease, they are placed in isolation and receive special care, with precautions taken to protect uninfected people from exposure to the disease.
When someone has been exposed to a contagious disease and it is not yet known if they have caught it, they may be quarantined or separated from others who have not been exposed to the disease. For example, they may be asked to remain at home to prevent further potential spread of the illness. They also receive special care and observation for any early signs of the illness.
How long can quarantine and isolation last? What is done to help the people who experience isolation or quarantine?
The list of diseases for which quarantine or isolation is authorized is specified in an Executive Order of the President. This list currently includes cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers (Lassa, Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named), Severe Acute Respiratory Syndrome (SARS), and influenza caused by novel or reemergent influenza viruses that are causing, or have the potential to cause, a pandemic.
Isolation
Isolation would last for the period of communicability of the illness, which varies by disease and the availability of specific treatment. Usually it occurs at a hospital or other health care facility or in the person’s home. Typically, the ill person will have his or her own room and those who care for him or her will wear protective clothing and take other precautions, depending on the level of personal protection needed for the specific illness.
In most cases, isolation is voluntary; however, federal, state and local governments have the authority to require isolation of sick people to protect the public.
Quarantine
Modern quarantine lasts only as long as necessary to protect the public by (1) providing public health care (such as immunization or drug treatment, as required) and (2) ensuring that quarantined persons do not infect others if they have been exposed to a contagious disease.
Modern quarantine is more likely to involve limited numbers of exposed persons in small areas than to involve large numbers of persons in whole neighborhoods or cities.
Quarantined individuals will be sheltered, fed, and cared for at home, in a designated emergency facility, or in a specialized hospital, depending on the disease and the available resources. They will also be among the first to receive all available medical interventions to prevent and control disease, including:
Vaccination.
Antibiotics.
Early and rapid diagnostic testing and symptom monitoring.
Early treatment if symptoms appear.
The duration and scope of quarantine measures would vary, depending on their purpose and what is known about the incubation period (how long it takes for symptoms to develop after exposure) of the disease-causing agent.
Examples
A few hours for assessment. Passengers on airplanes, trains or boats believed to be infected with or exposed to a dangerous contagious disease might be delayed for a few hours while health authorities determine the risk they pose to public health. Some passengers may be asked to provide contact information and then released while others who are ill are transported to where they can receive medical attention. There have been a few instances where state and local public health authorities have imposed a brief quarantine at a public gathering, such as a shelter, while investigating if one or more people may be ill.
Enough time to provide preventive treatment or other intervention. If public health authorities determine that a passenger or passengers on airplanes, trains or boats are sick with a dangerous contagious disease, the other passengers may be quarantined in a designated facility where they may receive preventive treatment and have their health monitored.
For the duration of the incubation period. If public health officials determine that one or more passenger on airplanes, trains or boats are infected with a contagious disease and that passengers sitting nearby may have had close contact with the infected passenger(s), those at risk might be quarantined in a designated facility, observed for signs of illness and cared for under isolation conditions if they become ill.
When would quarantine and isolation be used and by whom?
If people in a certain area were potentially exposed to a contagious disease, this is what would happen: State and local health authorities would let people know that they may have been exposed and would direct them to get medical attention, undergo diagnostic tests, and stay at home, limiting their contact with people who have not been exposed to the disease. Only rarely would federal, state, or local health authorities issue an “order” for quarantine and isolation.
However, both quarantine and isolation may be compelled on a mandatory basis through legal authority as well as conducted on a voluntary basis.
States have the authority to declare and enforce quarantine and isolation within their borders. This authority varies widely, depending on state laws. It derives from the authority of state governments granted by the U.S. Constitution to enact laws and promote regulations to safeguard the health and welfare of people within state borders.
Further, at the national level, the CDC may detain, medically examine or conditionally release persons suspected of having certain contagious diseases. This authority applies to individuals arriving from foreign countries, including Canada and Mexico, on airplanes, trains, automobiles, boats or by foot. It also applies to individuals traveling from one state to another or in the event of “inadequate local control.”
The CDC regularly uses its authority to monitor passengers arriving in the United States for contagious diseases. In modern times, most quarantine measures have been imposed on a small scale, typically involving small numbers of travelers (airline or cruise ship passengers) who have curable diseases, such as infectious tuberculosis or cholera. No instances of large-scale quarantine have occurred in the U.S. since the “Spanish Flu” pandemic of 1918-1919.
Based on years of experience working with state and local partners, the CDC anticipates that the need to use its federal authority to involuntarily quarantine a person would occur only in rare situations—for example, if a person posed a threat to public health and refused to cooperate with a voluntary request.
Infectious disease: a disease caused by a microorganism and therefore potentially infinitely transferable to new individuals. May or may not be communicable. Example of non communicable is disease caused by toxins from food poisoning or infection caused by toxins in the environment, such as tetanus.
Communicable disease: an infectious disease that is contagious and which can be transmitted from one source to another by infectious bacteria or viral organisms.
Contagious disease: a very communicable disease capable of spreading rapidly from one person to another by contact or close proximity.
White House Pushes Back on State Ebola Quarantines
By
COLLEEN MCCAIN NELSON,
MELANIE GRAYCE WEST and
BETSY MCKAY
The White House pushed back against the governors of New York, New Jersey, Illinois and other states that instituted procedures to forcibly quarantine medical workers returning from West Africa, deepening an emotional debate brought on by recent Ebola cases in the U.S.
A senior administration official said Sunday that new federal guidelines under development would protect Americans from imported cases of the disease but not interfere with the flow of U.S. health workers to and from West Africa to fight the epidemic there.
“We have let the governors of New York, New Jersey and other states know that we have concerns with the unintended consequences… [that quarantine] policies not grounded in science may have on efforts to combat Ebola at its source,” the official said.
Betsy McKay joins the News Hub with the latest on the spread of the Ebola virus and efforts to contain it in the U.S. Photo: University of Texas at Arlington/AP.
It wasn’t clear what action the Obama administration could take to end the quarantines.
New York Gov. Andrew Cuomo on Sunday night gave the first new details about how his state’s quarantine would work, noting that individuals would be allowed to stay in their homes for 21 days. State and local health-care workers would check on quarantined people twice a day to monitor for Ebola symptoms. Those with symptoms would be taken to a hospital. People whose jobs won’t compensate them during their quarantine would be paid by the state.
Travelers who have had no direct contact with Ebola patients wouldn’t be subject to confinement at home, but they would be consulted twice-daily by health officials over the three-week period.
New York officials said the new protocols still went further than those recommended by the federal government.
“My personal practice is to err on the side of caution,” said Mr. Cuomo. Asked if he got White House pressure to shape the policy, Mr. Cuomo said: “I have had none.”
The New York quarantine policy appears designed to strike a different tone from New Jersey, where Kaci Hickox, a 33-year-old Doctors Without Borders nurse, has been held in a tent in a Newark hospital for three days under conditions that she said Sunday were “really inhumane.”
New Jersey state officials said late Sunday night that they wouldn’t change their protocols, which allowed for home quarantine. A New Jersey resident who has no symptoms but has come into contact with someone with Ebola would be quarantined at home. Non-residents would be transported to their homes if feasible, or quarantined in New Jersey if not.
Ms. Hickox, who lives in Maine, has retained lawyers to challenge her quarantine. One of those lawyers, Norman Siegel, a prominent civil rights attorney, said the quarantine policy infringed on her constitutional rights.
New Jersey Gov. Chris Christie held firm on his decision to quarantine returning health-care workers. “I absolutely have no second thoughts about it,” he said on Fox News.
Mr. Cuomo’s announcement on Sunday was made with New York Mayor Bill de Blasio , who had criticized how Ms. Hickox was treated. “State governments have the right to make decisions. But this hero coming back from the front, having done the right thing, was treated with disrespect,” Mr. de Blasio told reporters.
Mr. Christie said Saturday that “I’m sorry if in any way she was inconvenienced, but inconvenience that could occur from having folks that are symptomatic and ill out amongst the public is a much, much greater concern of mine. So certainly nothing was done intentionally to try to inconvenience her or try to make her uncomfortable.”
Although Mr. Cuomo’s policy appears different from New Jersey’s handling of a quarantine case, the White House declined to comment on the New York measures beyond reiterating the principles guiding its own decision-making.
Ebola has killed nearly 5,000 people in West Africa. Nine people have been treated for the virus in the U.S., four of whom either became ill or were infected here. One died.
President Barack Obama convened a meeting of top public health and national security advisers on Sunday to discuss the issue.
Federal, state and local officials are grappling with ways to quell anxiety and protect the public. The different approaches they are taking reflect the layered public health system in the U.S. State and local authorities hold most quarantine powers, while the federal government’s power is more limited, according to legal experts.
The federal government technically could find an argument for challenging state decisions to impose quarantines, said Polly Price, professor at Emory University School of Law. “I could see an argument that there are interstate ramifications,” she said, such as economic disruption. But she said she thought it unlikely, given the political environment and public anxiety over Ebola.
In most cases, the federal government can’t override state quarantines. The Centers for Disease Control and Prevention has powers at ports of entry to the U.S., and can quarantine people who are traveling between states and have infectious diseases such as tuberculosis. Ebola, which can’t be spread through the air, isn’t considered as infectious.
ENLARGE
New York Governor Andrew Cuomo, left, and New Jersey Governor Chris Christie announced a mandatory quarantine for “high risk” people returning to the U.S. through airports in New York and New Jersey. ASSOCIATED PRESS
Craig Spencer, a New York doctor diagnosed Thursday with Ebola after his return from West Africa, appeared to have played a part in the quarantine moves by New Jersey and New York. He was reported in serious but stable condition Sunday at Bellevue Hospital Center in Manhattan.
The Christie administration believes it would win any legal challenge because state law is clear on the government’s ability to quarantine people in public-health emergencies, said a New Jersey state official familiar with the new policy.
During a campaign stop in Florida Sunday, Mr. Christie said that no federal officials had reached out to him about revising the mandatory quarantine.
Christie administration officials knew that public-health experts would disagree with their decision but decided they wanted a broad, tough policy that would calm people’s fears, a Christie official said.
Mr. Cuomo said last week that he consulted with the Centers for Disease Control and Prevention before launching the mandatory-quarantine policy, but Christie administration officials didn’t, a Christie spokesman said.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, said Sunday that the administration is considering a risk-based monitoring system that would elevate the required supervision of health-care workers returning from West African nations.
But he said the protocols would stop short of a mandatory, 21-day isolation of health-care workers that several states have imposed, which risks deterring volunteers heading to Africa to fight the disease.
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“You fashion what you do with them according to the risk,” Dr. Fauci said Sunday morning on NBC. “One of the ways you can mitigate against this issue is by…different types of monitoring.”
Supervision would ratchet up from passive monitoring—individuals regularly taking their temperatures—to “direct active” monitoring, where those who are deemed high-risk are checked by medical workers, he said on NBC.
Scientists say that people who aren’t showing symptoms of Ebola don’t transmit the disease, and Dr. Fauci said other steps besides a mandatory quarantine could ensure public safety. Telling health-care workers that upon returning from West Africa “you still have 21 days out of your life where you can’t move, I think, will have unintended negative consequences,” he said.
Legal experts disagreed on Ms. Hickox’s ability to successfully challenge her quarantine.
Lawrence Gostin, a Georgetown University professor who leads the O’Neill Institute for National and Global Health Law, and is offering help to Ms. Hickox, said she has two main ways to contest her quarantine. The policy in New Jersey applies to a class of people and there “was no individualized assessment of her individual risk,” he said.
The second possible avenue is to argue she wasn’t quarantined in a humane health environment.
“Because this is not a prison sentence, the person has not been convicted. It’s civil and so you’re not supposed to punish them,” said Mr. Gostin.
Mr. Gostin said this was the first time in his memory where such a quarantine was implemented.
But Michael C. Dorf, a professor at Cornell University Law School, said there may not be a sound legal case to challenge a quarantine. The state laws used to implement mandatory quarantines in New York, New Jersey and Illinois are clear and “there is no serious doubt about the affirmative power of either the states and the federal government to quarantine,” Mr. Dorf said
Army major general, troops quarantined after Ebola aid trip
By Barbara Starr,
Army Major General Darryl A. Williams, commander of U.S. Army Africa, and approximately 10 other personnel are now in “controlled monitoring” in Italy after returning there from West Africa over the weekend, according to multiple U.S. military officials.
The American personnel are effectively under quarantine, but Pentagon officials declined to use that terminology.
Williams’ plane was met on the ground by Italian authorities “in full CDC gear,” the official said, referring to the type of protective equipment worn by U.S. health care workers.
There is no indication at this time any of the team have symptoms of Ebola.
They will be monitored for 21 days at a “separate location” at the U.S. military installation at Vicenza Italy, according to U.S. military officials. Senior Pentagon officials say it is not a “quarantine,” but rather “controlled monitoring.” However, the troops are being housed in an access controlled location on base, and are not allowed to go home for the 21 day period while they undergo twice daily temperature checks.
It is not clear yet if they will be allowed visits from family members.
Williams and his team have been in West Africa for 30 days, to set up the initial U.S. military assistance there and have traveled extensively around Liberia. The team was in treatment and testing areas during their travels.
Speaking to reporters two weeks ago while he was still overseas in Liberia, Williams spoke of the extensive monitoring that he was given.
U.S. troops join Ebola fight
“We measure, while we’re here — twice a day, are monitoring as required by the recent guidance that was put out while we’re here in Liberia. I — yesterday, I had my temperature taken, I think, eight times, before I got on and off aircraft, before I went in and out of the embassy, before I went out of my place where I’m staying,” William said during the October 16 press conference.
“As long as you exercise basic sanitation and cleanliness sort of protocols using the chlorine wash on your hands and your feet, get your temperature taken, limiting the exposure, the — no handshaking, those sorts of protocols, I think the risk is relatively low.”
Officials could not explain why the group was being put under into controlled monitoring, which is counter to the Pentagon policy. The current DOD policy on monitoring returning troops says “as long as individuals remain asymptomatic, they may return to work and routine daily activities with family members.”
White House Press Secretary Josh Earnest said Monday that the Defense Department “has not issued a policy related to their workers that have spent time in West Africa.”
“I know that there was this decision that was made by one commanding officer in the Department of Defense, but it does not reflect a department-wide policy that I understand is still under development,” Earnest said.
The Pentagon has, though, published plans that detail how it will handle troops who are deployed to the region — including potential quarantines.
Jessica L. Wright, the undersecretary of Defense for personnel and readiness, issued an Oct. 10 memo that said troops who have faced an elevated risk of exposure to Ebola will be quarantined for 21 days — and that those who haven’t faced any known exposure will be monitored for three weeks.
Wright’s memo also lays out the Pentagon’s plans to train troops before they’re sent to West Africa and to monitor them during their deployment to the epicenter of the Ebola outbreak.
Pressed again during his briefing Monday, Earnest said it’s up to the Defense Department to announce its policies for troops that return from the region.
“We are seeing this administration put in place the policies that we believe are necessary to protect the American people and to protect the American troops,” he said. “And we’re going to let science drive that process. And as soon as we have a policy to announce on this, we’ll let you know.”
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Note: They are not wearing a
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You Decide
Frank Sinatra-New York,New York
Frank Sinatra-New York,New York-Lyrics
Start spreadin’ the news, I’m leavin’ today
I want to be a part of it
New York, New York
These vagabond shoes, are longing to stray
Right through the very heart of it
New York, New YorkI want to wake up, in a city that never sleeps
And find I’m king of the hill
Top of the heapThese little town blues, are melting away
I’ll make a brand new start of it
In old New York
If I can make it there, I’ll make it anywhere
It’s up to you, New York..New YorkNew York…New York
I want to wake up, in a city that never sleeps
And find I’m A number one, top of the list
King of the hill, A number one….These little town blues, are melting away
I’ll make a brand new start of it
In old New York
If I can make it there, I’ll make it anywhere
It’s up to you, New York..New York New York!!!
Frank Sinatra – New York New York Song **Lyrics** [HD]
My Kind of Town (Chicago) – Frank Sinatra
“My Kind Of Town”
Now this could only happen to a guy like me
And only happen in a town like this
So may I say to each of you most gratef’lly
As I throw each one of you a kissThis is my kind of town, Chicago is
My kind of town, Chicago is
My kind of people, too
People who smile at youAnd each time I roam, Chicago is
Calling me home, Chicago is
Why I just grin like a clown
It’s my kind of town[brief instrumental]My kind of town, Chicago is
My kind of town, Chicago is
My kind of razzmatazz
And it has all that jazzAnd each time I leave, Chicago is
Tuggin’ my sleeve, Chicago is
The Wrigley Building, Chicago is
The Union Stockyard, Chicago is
One town that won’t let you down
It’s my kind of town
New York, New Jersey Set Up Mandatory Quarantine Requirement Amid Ebola Threat Christie: New Policy Has Already Been Used At Newark Liberty International Airport
As CBS 2’s Alice Gainer reported, no other states have yet set up increased screening procedures for Ebola.
“We believe it’s appropriate to increase the current screening procedures from people coming from affected countries from the current (Centers for Disease Control and Prevention screening procedures),” Gov. Andrew Cuomo said Friday afternoon. “We believe it within the State of New York and the State of New Jersey’s legal rights.”
Under the new rules, state officials will establish a risk level by considering the countries that people have visited and their level of possible exposure to Ebola.
The patients with the highest level of possible exposure will be automatically quarantined for 21 days at a government-regulated facility. Those with a lower risk will be monitored for temperature and symptoms, Cuomo explained.
The New York and New Jersey health departments will determine their own specific procedures for hospitalization and quarantine, and will provide a daily recap to state officials on the status of screening, New York State Health Commissioner Dr. Howard Zucker said at the news conference.
The new procedures already have been put into use at Newark Liberty International Airport.
On Friday, a health care worker landed at Newark after treating Ebola patients in West Africa, New Jersey Gov. Chris Christie said at the news conference. A legal quarantine was issued for the woman, who was not a New Jersey resident and was set to go on to New York afterward.
“This woman, while her home residence is outside the area, said her next stop was going to be here in New York,” Christie said. “Governor Cuomo and I discussed it before we came out here, and a quarantine order will be issued.”
The woman will be quarantined in either New York or New Jersey, Christie said.
In discussing the new plan, Cuomo and Christie said a policy of voluntary quarantine simply does not go far enough.
“Voluntary quarantine – you know it’s almost an oxymoron. This is a very serious situation.” Cuomo said. “Voluntary quarantine – raise your right hand and promise you’re going to stay home for 21 days. We’ve seen what happens.”
The new rules were announced a day after Dr. Craig Spencer, a member of Doctors Without Borders, became New York City’s first Ebola patient.
He reported Thursday morning coming down with a fever and diarrhea and is being treated in an isolation ward at Bellevue Hospital, a designated Ebola center.
Spencer returned from West Africa last Friday after treating Ebola patients in Guinea with Doctors Without Borders. He arrived at John F. Kennedy International Airport, passing the extensive CDC screening process.
“When he arrived in the United States, he was also well with no symptoms,” said New York City Health Commissioner Mary Travis Bassett.
Doctors Without Borders said per the guidelines it provides its staff members on their return from Ebola assignments, “the individual engaged in regular health monitoring and reported this development immediately.” But Spencer also took the subway, walked the High Line, and went bowling in Williamsburg, Brooklyn the day before he became sick.
“He was a doctor, and even he didn’t follow the guidelines,” Cuomo said.
With that in mind, the states have to lay down the law, the governors said.
“It’s too serious a situation to leave it to the honor system,” Cuomo said.
The CDC is reviewing its policy for health care workers returning from West Africa, but anyone flying into a Port Authority of New York and New Jersey airport will need to abide by the new procedures.
Ebola Arrives in New York. How Prepared Is the City to Handle It?
Dr. Craig Spencer, the health care worker who recently returned from Guinea and tested positivefor the Ebola virus, is now the first patient to be treated at New York’s Bellevue Hospital.
But the hospital, as well as city, state and federal officials, have been working for weeks or more to ensure the city is ready to identify and treat Ebola cases.
This preparation reflects the now-proven fact that the longer the outbreak rages on in West Africa, the more likely it was that a patient would wind up in Western cities, including New York.
On Oct. 15, the state designated Bellevue Hospital Center as the facility to receive Ebola patients from among the city’s 11 public hospitals, and to receive transferred patients from other hospitals as well, in the event that any Ebola cases occur in the city.
According to a statement from the New York City Health and Hospitals Corporation, the hospital has four single-bed rooms in its infectious disease ward to treat “high probability or confirmed Ebola cases.” This part of the hospital also has a new laboratory that can test for Ebola, separate from the rest of the hospital’s labs, to handle Ebola blood samples.
Because the virus can be spread through contact with an infected person’s bodily fluids, careful handling of blood and other samples is necessary.
The hospital is particularly well suited due to its long history of being on the front lines of epidemics and emerging public health threats, and managing an isolation unit for diseases, such as TB, for many years with support from and collaboration with the City Health Department.
Three other hospitals in New York City have also been designated by the state to treat suspected and confirmed Ebola cases, including Mt. Sinai and New York Presbyterian in Manhattan and Montefiore in the Bronx, according to Governor Cuomo’s Ebola preparedness plan.
None of these hospitals, including Bellevue, has an isolated biocontainment unit like those that have treated patients at Emory University Hospital in Atlanta, Georgia, and Nebraska Medical Center in Omaha, Nebraska.
The American public may not have much faith in ordinary hospitals to treat Ebola, considering that the only non-specialized hospital to treat Ebola patients, Texas Health Presbyterian Hospital Dallas, allowed the virus to spread to two nurses who worked on the original patient, Thomas Eric Duncan, who died of Ebola on Oct. 8. Both of the nurses are now being treated in a biocontainment unit.
The probability of an Ebola case in New York was always considerably higher than it was for many other cities in the U.S., given that two of the city’s international airports — JFK and Newark — are key gateways for travelers to and from West Africa, via stops in Europe or elsewhere in Africa.
“New York City is a frequent port of entry for travelers from West Africa, a home to communities of West African immigrants who travel back to their home countries, and a home to health care workers who travel to West Africa to treat Ebola patients,” The Centers for Disease Control and Prevention (CDC) said in a report on Oct. 17.
“Ongoing transmission of Ebola virus in West Africa could result in an infected person arriving in NYC,” the report said. However, the chance that a New Yorker who has not traveled to an Ebola hotspot would come down with the virus is “extremely slim,” since the disease is only spread through direct contact with an infectious person’s bodily fluids.
Ultimately, it was a doctor who lived in the city who would bring the virus home.
In recent weeks, the New York Health Commissioner issued a “Commissioner’s Order” to all hospitals and ambulance services in the state, “requiring that they follow protocols for identification, isolation and medical evaluation of patients requiring care.”
The state has been conducting “unannounced drills” at hospitals and health care facilities to test preparedness for handling possible Ebola cases. The state has also involved the Metropalitan Transit Authority, which operates the city’s subways and buses, in training for encountering possible Ebola patients.
And a mass Ebola training for health care workers, which included demonstrations for putting on and taking off protective equipment, took place in the city on Oct. 21.
According to new guidelines the CDC issued on Monday, there are now 30 steps health care workers have to take every time they treat a patient with Ebola or Ebola-like symptoms.
At hospitals like Bellevue, actors have played the role of patients with Ebola symptoms have been part of the drills, and the city’s 911 operators have been told to ask people who call in with Ebola-like symptoms if they have recently traveled to West Africa, according to the Guardian.
As of Thursday, there have been nearly 10,000 cases of Ebola in West Africa, along with about 4,900 deaths. However, these figures are likely to be underestimates, since the lack of treatment facilities and other circumstances are causing many patients to go uncounted.
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Five U.S. airports begin screening for Ebola among travelers from West Africa
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Gov. Perry Announces North Texas Infectious Disease Bio Containment Facility
Gov. Rick Perry today announced the creation of a state-of-the-art Ebola treatment and infectious disease bio containment facility in North Texas. Creation of such facilities was among the first recommendations made by the governor’s recently named Texas Task Force on Infectious Disease Preparedness and Response in order to better protect health care workers and the public from the spread of pandemic diseases.
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Americans want flight restrictions from Ebola countries. And it’s not close.
By Aaron Blake
Nearly two-thirds of Americans say they are concerned about an Ebola outbreak in the United States, and about the same amount say they want flight restrictions from the countries in West Africa where the disease has quickly spread.
A new poll from the Washington Post and ABC News shows 67 percent of people say they would support restricting entry to the United States from countries struggling with Ebola. Another 91 percent would like to see stricter screening procedures at U.S. airports in response to the disease’s spread.
Thus far, some countries in Europe have restricted flights from these countries in West Africa, and an increasing number of U.S. lawmakers are calling for similar bans. The White House has yet to increase restrictions, with federal officials saying such a move could actually increase the spread of the disease by hampering the movement of aid workers and supplies.
Concern about Ebola, at this point, is real but not pervasive. About two-thirds (65 percent) say they are concerned about an Ebola outbreak in the United States. But while people are broadly concerned about an outbreak, they are not necessarily worried about that potential outbreak directly affecting them. Just 43 percent of people are worried about themselves or someone in their family becoming infected – including 20 percent who are “very worried.”
That finding echoes a Pew poll from last week which showed just 11 percent were “very worried” about themselves or their families becoming infected. Since that survey, Dallas Ebola patient Thomas Eric Duncan died, and news that a nurse who provided care for him became infected broke on the final day of the Post-ABC poll.
By comparison, slightly more Americans said they were worried about the H1N1 virus – a.k.a. the swine flu – in October 2009 (52 percent). Concern about Ebola is about on-par with concern about Avian influenza – a.k.a. the bird flu – in 2006 (41 percent) and slightly higher than concern about Sudden Acute Respiratory Syndrome (SARS) in 2003 (as high as 38 percent).
The support for increasing restrictions puts the White House in a tough spot. Given the moves by other countries and the American public’s stance, there is increasing pressure to act. And given the very real — but still somewhat muted — concerns about the disease, that’s significant, especially if the disease continues to expand.
The Department of Homeland Security announced Tuesday that all travelers from Ebola outbreak countries in West Africa will be funneled through one of five U.S. airports with enhanced screening starting Wednesday.
Customs and Border Protection within the department began enhanced screening — checking the traveler’s temperature and asking about possible exposure to Ebola — at New York’s John F. Kennedy International Airport on Oct. 11.
Enhanced screening for travelers from Liberia, Sierra Leone and Guinea was expanded Oct. 16 to Washington Dulles, Chicago O’Hare, New Jersey’s Newark and Hartsfield-Jackson Atlanta international airports.
Those airports were supposed to screen 94% of the average 150 people per day arriving from the three countries. Lawmakers from other states asked for enhanced screening at their airports, too.
Some lawmakers have called for more restrictions, such as suspending visas or denying entry at ports for citizens from the three countries.
Jeh Johnson, secretary of Homeland Security, announced that travelers from West Africa must arrive at one of the five airports starting Wednesday.
“We are working closely with the airlines to implement these restrictions with minimal travel disruption,” Johnson said. “If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking as needed.”
The enhanced screening will apply to anyone who traveled recently to, from or through the three outbreak countries, according to the department’s announcement to be published Thursday in the Federal Register. Customs and Border Protection will work with airlines to identify potential travelers before they board, but airlines will be obligated to comply with the rule for carrying to the USA any passengers who recently traveled through the region, according to the filing.
The restrictions should affect only about nine travelers per day who would have arrived at other airports. Katie Cody, a spokeswoman for American Airlines, which serves Europe from hubs such as Philadelphia and Charlotte, said the airline has no concerns about the change.
“We have been tracking that, and we don’t have any concerns because the numbers are so small,” Cody said.
British Airways, which serves a variety of U.S. destinations other than the five targeted airports, said it would comply with the measures.
“Customers affected will be offered a refund or will be rerouted if there is availability,” spokeswoman Michele Kropf said.
Republican lawmakers offered muted praise but pressed for stricter travel restrictions.
“In addition to requiring all travelers from at-risk countries to fly through airports with enhanced screening measures in place, I continue to call on the administration to suspend all visas from Liberia, Sierra Leone and Guinea,” said Rep. Michael McCaul, R-Texas, the head of the House Homeland Security Committee.
The head of the House Judiciary Committee, Rep. Bob Goodlatte, R-Va., said a “real solution” is to deny entry to anyone from the three countries under a provision of the 1952 Immigration and Nationality Act.
“President Obama has a real solution at his disposal under current law and can use it at any time to temporarily ban foreign nationals from entering the United States from Ebola-ravaged countries,” Goodlatte said. “The vast majority of Americans strongly support such a travel moratorium, and I urge the president to take every step possible to protect the American people from danger.”
Rep. John Conyers of Michigan, the top Democrat on the House Judiciary Committee, said steering travelers through the five airports is a sensible precaution.
“As agreed upon by experts in both the public health and transportation communities, issuing a blanket travel ban would not only be counterproductive, but it would also irresponsibly impede getting much-needed supplies and relief to the countries that need it most,” Conyers said.
Roger Dow, CEO of the U.S. Travel Association, a trade group for all aspects of travel, praised the move to calm travel concerns while avoiding a travel ban.
“The Obama administration continues to heed the counsel of an overwhelming consensus of health and security experts and resist calls for any sort of travel ban on the grounds that it will be counterproductive to efforts to contain Ebola,” Dow said.
A Liberian national, Thomas Eric Duncan, who became the first person diagnosed with the disease in the USA after arriving in Dallas on Sept. 20, had a temperature of 97.3 degrees but didn’t tell airport officials in Monrovia, Liberia, that he had cared for a pregnant woman suffering from Ebola. He died Oct. 8, and two nurses who treated him have become infected.
Sen. Charles Schumer, D-N.Y., said the enhanced screening adds a layer of protection against Ebola entering the country.
“The Department of Homeland Security’s policy to funnel all passengers arriving from Ebola hot spots to one of these five equipped airports is a good and effective step towards tightening the net and further protecting our citizens,” Schumer said.
Obama and Johnson have said they will continue to monitor travel restrictions for possible changes.
“We are continually evaluating whether additional restrictions or added screening and precautionary measures are necessary to protect the American people and will act accordingly,” Johnson said.
Gabbard Calls On CDC To Increase Incubation Period To Prevent Ebola Spread
By Chad Blair
Rep. Tulsi Gabbard (D-HI) has called on the Center for Disease Control to implement stricter incubation guidelines for people who have been in contact with patients “confirmed or suspected” to have the Ebola virus.
According to a press release from her office, Gabbard is calling on the CDC to increase the quarantine and restriction period from the 21-day standard to 42 days, “based on the latest scientific studies and the World Health Organization report that the incubation period for the deadly Ebola virus can extend as long as 42 days.”
On Friday, Gabbard called for the “immediate suspension” of visas for citizens of Ebola-stricken West African nations as well as flights from those countries into the United States.
“Recent mistakes have revealed that the U.S. public health system is clearly not fully prepared to combat Ebola and prevent its spread in the United States,” she said in a statement.
Democrats like Gabbard are among a growing number who are “beginning to sound more like Republicans when they talk about Ebola. And Republicans are moving into overdrive with their criticism of the government’s handling of the deadly virus,” according to The Washington Post.
“The sharpened rhetoric, strategists say, suggests Democrats fear President Obama’s response to Ebola in the United States could become a political liability in the midterm election and Republicans see an opportunity to tie increasing concerns about the disease to the public’s broader worries about Obama’s leadership.”
The Washington Post notes, however, that Gabbard is “a liberal Democrat who is not in any danger of losing reelection.” It also reports that a Washington Post-ABC News poll showed that “67 percent of Americans would support restricting entry to the United States from countries fighting dealing with an Ebola crisis.”
How is the end of an Ebola outbreak decided and declared?
Information note – October 2014
Who decides the date?
The WHO Ebola outbreak response team is responsible for establishing the date of the end of the outbreak in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory.
How is the date determined?
An Ebola virus disease outbreak in a country can be declared over once 42 days have passed and no new cases have been detected. The 42 days represents twice the maximum incubation period for Ebola (21 days). This 42-day period starts from the last day that any person in the country had contact with a confirmed or probable Ebola case.
This includes health care workers who have been exposed to patients with Ebola virus disease, even if the health worker was wearing personal protective equipment and followed infection control procedures since such a person could be exposed accidentally without realizing it. In the setting of an Ebola treatment centre, the date of the last infectious contact is defined as the day when the last patient in the treatment centre tested negative for Ebola virus disease, using a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test.
If no new case has been detected at the end of this 42-day period, the risk of a further case is very low, and the outbreak is declared over.
Why 42 days?
The maximum incubation period for Ebola virus disease is 21 days. The 42-day period set by WHO (twice the maximum incubation period) provides a margin of security to cover any possible missed cases, uncertainty in reporting dates or hidden chains of transmission. (*)
During the 42-day period, the surveillance system should be fully functional, so that all contacts of the last patient are followed to detect possible chains of transmission.
What is the procedure to make the declaration?
The WHO Ebola outbreak response team in collaboration with the affected country’s subcommittee for surveillance, epidemiology and laboratory determines the date of the end of the epidemic. The government of the affected country, in collaboration with WHO and international partners, makes an official declaration of the end of the epidemic.
The Obama administration has reversed course on putting travel restrictions on those coming from three West African nations tainted with Ebola and is putting in place demands that they enter only through five U.S. airports prepared to screen for the virus.
Homeland Security Secretary Jeh Johnson said in a statement that the new rules will take effect Wednesday, bowing to demands from both parties that the U.S. do a better job so secure the border from Ebola.
“Today, as part of the Department of Homeland Security’s ongoing response to prevent the spread of Ebola to the United States, we are announcing travel restrictions in the form of additional screening and protective measures at our ports of entry for travelers from the three West African Ebola-affected countries,” said Johnson.
He said the rules require that anyone coming from Liberia, Sierra Leone or Guinea enter the U.S. only through the five airports where special Ebola screenings have been set up: New York’s John F. Kennedy, Newark Liberty, Washington Dulles, Atlanta’s Hartsfield-Jackson and Chicago’s O’Hare.
“All passengers arriving in the United States whose travel originates in Liberia, Sierra Leone or Guinea will be required to fly into one of the five airports that have the enhanced screening and additional resources in place. We are working closely with the airlines to implement these restrictions with minimal travel disruption. If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking, as needed,” said the statement.
He said that passengers flying into those airports on flights originating in Liberia, Sierra Leone and Guinea “are subject to secondary screening and added protocols, including having their temperature taken, before they can be admitted into the United States. These airports account for about 94 percent of travelers flying to the United States from these countries.”
There are no direct, non-stop commercial flights from Liberia, Sierra Leone or Guinea to the U.S.
Gov. Perry Announces North Texas Ebola Treatment and Infectious Disease Bio Containment Facility
Gov. Rick Perry today announced the creation of a state-of-the-art Ebola treatment and infectious disease bio containment facility in North Texas. Creation of such facilities was among the first recommendations made by the governor’s recently named Texas Task Force on Infectious Disease Preparedness and Response in order to better protect health care workers and the public from the spread of pandemic diseases.
In addition to the North Texas facility, The University of Texas Medical Branch at Galveston has also been designated an Ebola treatment and infectious disease bio containment facility.
“In the event of another diagnosis this facility will allow us to act quickly to limit the virus’ reach and give patients the care they need in an environment where health care workers are specially trained and equipped to deal with the unique requirements of this disease,” said Gov. Perry. “We are fortunate to have such talented and dedicated leaders here in North Texas, and at UTMB Galveston, who are willing to step forward during a time of need.”
Three of the region’s leading health care providers, UT Southwestern Medical Center, Methodist Health System and Parkland Hospital System, will partner to set up and operate the North Texas facility. The facility and equipment are being provided by partner hospitals, and staffing will be moved to the facility on an as-needed basis if the unit is activated.
UT Southwestern Medical Center is contributing the expertise of physicians experienced in infectious disease, critical care and other specialties, and some nursing professionals as staffing requires.
Methodist Health System is allowing the use of an entire floor of the Methodist Campus for Continuing Care in Richardson, including an ICU wing well suited for the care of infectious disease patients. They will provide some modifications for the critical steps of decontamination, laboratory equipment and other dedicated personnel for IT and biomedical support. Ebola and/or other infectious disease patients can be safely isolated
Parkland Hospital has already begun transferring critical equipment such as personal protective equipment, IV fluids and laboratory supplies to the Methodist facility. In addition, Parkland will provide nurses, pharmacists, respiratory therapists and lab technicians.
“UT Southwestern is proud that its expert faculty physicians and nurses are ready to lead in providing the very best care possible while safeguarding the safety of staff and the public. UTSW is also committed to advancing the other important longer term goals identified by the Governor’s Task Force,” said Dr. Daniel K. Podolsky, President, UT Southwestern Medical Center Building on the foundations that have made it an academic medical center that is respected worldwide, UTSW is committed to the education and training of caregivers broadly and to promote research which will improve disease treatment and prevention. There is no mission greater than serving the public good.”
“Methodist Health System answered the call because it is the right thing to do,” said Stephen L. Mansfield, PhD, FACHE, president and CEO, Methodist Health System. “Like all North Texans, we wish we weren’t in this situation. But the reality is there remains a threat, and as long as it’s there, Methodist is obligated by our mission — to improve and save lives through compassionate, quality health care — to do all we can to help.”
“Parkland is proud to be a part of this team effort to protect Texans from infectious disease. Our health system has a long history of emergency preparedness and clinical innovation so we are a great fit for this strike force,” said Frederick P. Cerise, MD, MPH, president and CEO, Parkland Health System. “Every Parkland employee comes to work knowing we may face the most difficult of situations and I am confident that we possess the skills and expertise to deal with them. Parkland also appreciates the leadership of Governor Perry as well as state and local officials in putting this team together.”
“UTMB is prepared to help fight Ebola and other infectious diseases,” said Dr. David L. Callender, UTMB president. “I have every confidence in our abilities to provide the highest level of care and we are proud that the governor has placed this trust in us as well as UT Southwestern, Methodist and Parkland.”
NIH unit treating Dallas nurse for Ebola is one of 4 special isolation facilities in U.S.
By Lena H. Sun
It has a specially designed air-flow system to prevent contaminated air from leaving the patient room. It requires anyone who enters to be buzzed in. Personnel who work there receive special training in infection control to prevent the spread of bioterror agents, natural or man-made. It also has a tiny gym.
Welcome to the Special Clinical Studies Unit at the National Institutes of Health in Bethesda, Md. It is a 4,000-square-foot unit inside the NIH Clinical Center, the nation’s only hospital dedicated to research, which provides free state-of-the-art care to very sick patients from all over the world.
Now it’s home to its first confirmed Ebola patient, Nina Pham.
Pham is the first patient with a confirmed infectious disease to be cared for in the special seven-bed unit, center director John Gallin said in an interview Friday. Opened in 2010 for patients who need advanced isolation and extended stays, the unit was initially designed to take care of personnel working at the U.S. Army Medical Research Institute of Infectious Diseases in case they were exposed to infectious agents. In more recent years, it has been used to house healthy volunteers participating in live vaccine trials. The volunteers need to be monitored in a place where they can be safely quarantined, Gallin said. To accommodate those healthy volunteers, the unit has a dining room and a “tiny fitness area,” he said.
Pham, the first nurse diagnosed with Ebola after caring for a patient in Dallas, is in fair and stable condition, officials said Friday morning.
What does an Ebola isolation ward look like?
“We are giving her the best possible care on a symptomatic and systemic basis,” Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, said during a news conference.
Pham, 26, was transferred to the facility, one of four in the country with a special biocontainment unit, late Thursday. She was diagnosed with Ebola on Sunday, becoming the first person to contract the disease on U.S. soil. Pham had been part of the team that treated Thomas Eric Duncan, a Liberian man who flew to Dallas last month before being diagnosed with Ebola. Duncan died last week, four days before it was announced that Pham had contracted the disease.
“There is no specific therapy that has been proven to be effective against Ebola, and that’s why excellent medical care is critical,” Fauci said. He said Pham was “very, very tired” from her trip.
Patients infected with the Ebola virus require a large number of staffers to provide care around-the-clock. At NIH, that comes out to about 27 people a week — doctors, nurses, support staff — for one patient, Gallin said. With about 50 to 60 such personnel specially trained for infectious disease and critical care, NIH can only care for two Ebola patients at a time, he said.
The four facilities that provide such care were designed in the aftermath of the Sept. 11, 2001, terrorist attacks to protect against bioterrorism. Two of them, Emory University Hospital in Atlanta and the Nebraska Medical Center, are each treating one Ebola patient. The other facility is St. Patrick Hospital in Missoula, Mont.
They require staff to undergo more rigorous training in infection control, and staff must follow strict protocol for putting on and taking off personal protective equipment in a separate anteroom. Officials say meticulous attention to detail in following protocols is what sets them apart from other facilities.
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Emory has treated three Ebola patients, all of whom have recovered. The University of Nebraska treated one patient who recovered and is now caring for a freelance NBC cameraman. St. Patrick has not yet treated an Ebola patient. The hospital has received so many inquiries that it has set up a special hotline where they are transcribed and forwarded to the appropriate departments.
Bruce Ribner gives a tour of the Emory University Hospital isolation unit which has been used for treatment of patients infected with the Ebola virus. (Emory University via YouTube)
Unlike the Dallas hospital where Pham and another nurse were infected, which officials said most likely occurred because of a breach of protocol involving personal protective equipment, no health workers taking care of the Ebola patients at the special facilities have become infected.
“There is a step-by-step, checklisted procedure to putting on your personal protective equipment for when you go in to the patient’s room to perform your duties and when you come out,” said Mark Rupp, medical director of Nebraska Medical Center’s infection control department, which includes the special unit. “That’s the big difference with what goes on in our unit and what goes on in a regular intensive-care unit.”
The facilities have one person whose only job is to make sure health-care workers put on and take off their protective equipment correctly. At NIH, this person is dubbed “the Watson,” Gallin said, for the sidekick to Sherlock Holmes.
The Watson “has the authority to stop everything at any moment if someone looks like they’re breaking protocol,” Gallin said. The Watson has a checklist, like a pilot’s preflight checklist, and everything has to be done in that order. If not, the Watson can “scream at them and tell them to stop,” Gallin said, which apparently happened at least once Thursday night when doctors and staff were admitting Pham.
The protective gear that health-care workers take off is autoclaved (sanitized via pressurized steam) and then incinerated. Equipment that is not disposable is disinfected according to the manufacturer’s directions. The units also have negative air pressure to prevent germs from spreading beyond patient rooms. For Ebola patients, contaminated air is not such a concern because the disease is not transmitted through the air, but through contact with bodily fluids.
The seven-bed, 4,000-square-foot biocontainment unit at the National Institutes of Health Clinical Center in Bethesda, Md., is a state-of-the-art facility built to keep the world’s scariest pathogens from escaping. The four U.S. facilities are all different — NIH’s even has a gym — but they contain many of the same things. This layout is based on the unit at Emory University in Atlanta.
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Fast Facts on US Hospitals
The American Hospital Association conducts an annual survey of hospitals in the United States. The data below, from the 2012 AHA Annual Survey, are a sample of what you will find in AHA Hospital Statistics, 2014 edition. The definitive source for aggregate hospital data and trend analysis, AHA Hospital Statistics includes current and historical data on utilization, personnel, revenue, expenses, managed care contracts, community health indicators, physician models, and much more.
AHA Hospital Statistics is published annually by Health Forum, an affiliate of the American Hospital Association. Additional details on AHA Hospital Statistics and other Health Forum data products are available at www.ahadataviewer.com. To order AHA Hospital Statistics, call (800) AHA-2626 or click on www.ahaonlinestore.com.
For further information or customized data and research, contact the AHA Resource Center at (312) 422-2050 or rc@aha.org.
*Registered hospitals are those hospitals that meet AHA’s criteria for registration as a hospital facility. Registered hospitals include AHA member hospitals as well as nonmember hospitals. For a complete listing of the criteria used for registration, please see Registration Requirements for Hospitals.
**Community hospitals are defined as all nonfederal, short-term general, and other special hospitals. Other special hospitals include obstetrics and gynecology; eye, ear, nose, and throat; rehabilitation; orthopedic; and other individually described specialty services. Community hospitals include academic medical centers or other teaching hospitals if they are nonfederal short-term hospitals. Excluded are hospitals not accessible by the general public, such as prison hospitals or college infirmaries.
***System is defined by AHA as either a multihospital or a diversified single hospital system. A multihospital system is two or more hospitals owned, leased, sponsored, or contract managed by a central organization. Single, freestanding hospitals may be categorized as a system by bringing into membership three or more, and at least 25 percent, of their owned or leased non-hospital preacute or postacute health care organizations. System affiliation does not preclude network participation.
**** Network is a group of hospitals, physicians, other providers, insurers and/or community agencies that work together to coordinate and deliver a broad spectrum of services to their community. Network participation does not preclude system affiliation.
Ebola has officially made it to the US, but there is absolutely no reason to freak out. That’s in large part thanks to Emory University Hospital’s state-of-the-art isolation ward, which is better-equipped to field Ebola cases than any ordinary hospital in the country. Here’s a look at the tech that keeps doctors and nurses safe.
Emory is one of four high-level biocontainment patient care units in the US; the others are located at the National Institutes of Health in Maryland, Rocky Mountain Laboratories in Montana, and the University of Nebraska Medical Center. We spoke with Dr. Angela Hewlett, associate medical director at the Nebraska Biocontainment Patient Care Unit — the largest of the four facilities — about biocontainment suits, wearing three pairs of gloves, and custom air pressure systems.
Perhaps the most comfort Hewlett was able to provide is that none of the super-fancy tech that these four high-level isolation wards have at their disposal is even necessary for Ebola. “There’s a big fear factor with this illness but really, these types of patients can taken care of at any good healthcare facility,” says Dr. Hewlett.
That’s because the Ebola virus easily dies outside of the human body, so unless you’ve been handling a sick person’s blood or feces, you are almost certainly A-OK. Ebola is pretty darn hard to get compared to an airborne disease like SARS or even the regular old flu. But with a mortality rate of up to 90 per cent — and over 50 per cent with the strain in the current outbreak — we still need to keep doctors and nurses as safe as we can. Here’s how Nebraska Biocontainment Unit keeps diseases like Ebola — and much, much worse — from spreading in the hospital.
Negative air pressure. As with Emory in Atlanta, the isolation unit in Nebraska is isolated from the rest of the general hospital. It runs on its own air circulation system, and the air is passed through a high-efficiency particulate air (HEPA) filter before it is vented outside of the building. That’s the same kind of precautions that you would see in a biosafety level 4 lab (the highest) that works with deadly or highly contagious diseases.
In addition, the biocontainment unit has negative air pressure, which means that air pressure inside the isolation rooms is slightly lower than that outside. Essentially, air is gently sucked into the room, so particles from inside the room can’t float out when you open a door. As another line of protection, ultraviolet lights zap any viruses or bacteria in the air or on surfaces.
Full-body suits and THREE pairs of gloves. The Biocontainment Unit is equipped with gear that covers you head to toe, in some places three times over. That includes personal respirators, headgear, full-body suits and gloves. Healthcare workers wear three pairs, including one thick pair that protects against needle accidents, and then two pairs of ordinary gloves so they have an extra pair to work with patients.
Entering and exiting the room becomes an elaborate production because putting on and taking off all the gear can take more than 10 minutes each way. A second person assists to make sure every piece of equipment is put on right and there are no rips or tears in any of the protective gear. Afterwards, every piece of equipment is wiped down to kill the pathogen; in the case of Ebola, simple bleach is enough to do the trick. The full-body suit is discarded after each use.
Training and training and training. Having fancy technology is great but not if you don’t know how to use it properly. “They have to go through really extensive training,” says Hewlett of the the 30-person team that works in the unit. They get 80 hours of training before they can begin, followed by monthly meetings and quarterly drills, where the photos in this post were taken.
It’s worth reiterating that most of this equipment and these procedures go above and beyond protecting for Ebola. The air systems and full-body suits are really there to guard against possible airborne diseases, like smallpox or SARS or some highly contagious avian flu viruses that may emerge in the future.
In fact, the CDC’s current guidelines for treating Ebola in U.S. hospitals require only gloves, goggles, a facemask, and a gown in most situations. Even if someone inadvertently brings Ebola to other hospitals, it’s highly unlikely to spread in the U.S. The situation is different in Africa, where inadequate equipment and fear of healthcare workers has contributed to the worsening situation.
A State Department official did visit Nebraska to see whether the unit would be ready to accept any Ebola patients in the future, though the facility hasn’t yet been used despite being open for nine years. There hasn’t been a disease serious enough to merit it. “This is good thing,” says Dr. Hewlett, “However with world travel the way it is, it is inevitable these things are going to come eventually.” If and when Ebola does come to the U.S. again, we are definitely prepared, which is not something we can say about what else may be coming down the line.
Pictures: University of Nebraska Medical Center
Obama names Ron Klain as Ebola ‘czar’
David Jackson
President Obama tapped veteran government insider Ron Klain to coordinate his administration’s efforts to contain the Ebola virus Friday.
Klain, a former chief of staff to Vice Presidents Joe Biden and Al Gore, is well-known by Obama and White House aides. He was selected for his management experience and contacts throughout the government, White House spokesman Josh Earnest said.
“He is the right person for the job,” Earnest said, particularly the challenge of “integrating the interagency response.”
Klain’s appointment marks a swift turnabout for Obama, who until Thursday had resisted calls to appoint a single official to run the government’s response to Ebola.
Asked Thursday about the prospect of an “Ebola czar,” Obama said, “It may make sense for us to have one person, in part just so that after this initial surge of activity, we can have a more regular process just to make sure that we’re crossing all the t’s and dotting all the i’s going forward.”
USA TODAY
From recounts to stimulus to Ebola: Ron Klain’s resume
Obama did not mention Klain’s appointment during a speech Friday to the Consumer Financial Protection Bureau, but he said his administration is taking an “all-hands-on-deck” approach to fighting Ebola.
The administration has come under increased pressure to name an anti-Ebola coordinator in the wake of news that two nurses in Dallas contracted the deadly virus. Both had treated a man who died of Ebola.
Klain played a high-profile file in Gore’s 2000 presidential campaign. Oscar-winning actor Kevin Spacey portrayed him in an HBO movie on that year’s Florida recount.
The Ebola response includes efforts to screen travelers from West African nations where Ebola has reached epidemic proportions and killed more than 4,500 people. Klain will help coordinate the assistance the U.S. military provides in West Africa.
Some Republican lawmakers criticized Obama for entrusting the job to a former government manager rather than a professional.
Rep. Andy Harris, R-Md., tweeted, “Worst ebola epidemic in world history and Pres. Obama puts a government bureaucrat with no healthcare experience in charge. Is he serious?”
Members of the public health community expressed surprise.
“When are they going to stop making mistakes?” said Robert Murphy, the director of the Center for Global Health at Northwestern University’s Feinberg School of Medicine. “We need a czar, but optimally a strong public health expert. I am so disappointed. This is not what we need.”
Physician Amesh Adalja, a spokesman for the Infectious Diseases Society of America, said, “It’s clear that there’s a desperate desire for an organized approach to dealing with this outbreak. I don’t necessarily think we need a disease-specific czar — we have one for HIV — but more of an emerging infectious diseases/biosecurity coordinator who reports to the president.”
The Ebola position is designed to be more managerial in nature, involving an array of government agencies ranging from the Pentagon to Health and Human Services.
“This is much broader than a medical response,” Earnest said.
As for Republican criticism, Earnest joked, “That’s a shocking development.” He noted that national elections are less than three weeks away.
Klain may weigh in on another question facing the administration: the prospect of a U.S. travel ban from West African nations where there have been Ebola outbreaks.
Obama and aides have disputed the need for a travel ban, questioning whether it would work and arguing that it might create unintended problems.
Thursday, Obama said experts in infectious diseases have told him “a travel ban is less effective than the measures that we are currently instituting that involve screening passengers who are coming from West Africa.”
Klain is likely to take a low key role publicly.
Earnest said Obama wasn’t looking for an Ebola expert but “an implementation expert.”
He confirmed Klain’s title: “Ebola response coordinator.”
Klain will report to two officials involved in the anti-Ebola effort: homeland security adviser Lisa Monaco and national security adviser Susan Rice.
Obama is pleased with the work of Monaco and Rice, but “given their management of other national and homeland security priorities, additional bandwidth will further enhance the government’s Ebola response,” a White House official said, speaking on condition of anonymity.
The president has long known Klain, who helped prepare him for debates with Mitt Romney during the 2012 presidential campaign.
Klain has been out of government since leaving Biden’s staff during Obama’s first term.
The administration’s Ebola evasions reveal its disdain for the American people.
The administration’s handling of the Ebola crisis continues to be marked by double talk, runaround and gobbledygook. And its logic is worse than its language. In many of its actions, especially its public pronouncements, the government is functioning not as a soother of public anxiety but the cause of it.
An example this week came in the dialogue between Megyn Kelly of Fox News andThomas Frieden, director of the Centers for Disease Control.
Their conversation focused largely on the government’s refusal to stop travel into the United States by citizens of plague nations. “Why not put a travel ban in place,” Ms. Kelly asked, while we shore up the U.S. public-health system?
Dr. Frieden replied that we now have screening at airports, and “we’ve already recommended that all nonessential travel to these countries be stopped for Americans.” He added: “We’re always looking at ways that we can better protect Americans.”
“But this is one,” Ms. Kelly responded.
Dr. Frieden implied a travel ban would be harmful: “If we do things that are going to make it harder to stop the epidemic there, it’s going to spread to other parts of—”
Ms. Kelly interjected, asking how keeping citizens from the affected regions out of America would make it harder to stop Ebola in Africa.
“Because you can’t get people in and out.”
“Why can’t we have charter flights?”
“You know, charter flights don’t do the same thing commercial airliners do.”
“What do you mean? They fly in and fly out.”
Dr. Frieden replied that limiting travel between African nations would slow relief efforts. “If we isolate these countries, what’s not going to happen is disease staying there. It’s going to spread more all over Africa and we’ll be at higher risk.”
Later in the interview, Ms. Kelly noted that we still have airplanes coming into the U.S. from Liberia, with passengers expected to self-report Ebola exposure.
Dr. Frieden responded: “Ultimately the only way—and you may not like this—but the only way we will get our risk to zero here is to stop the outbreak in Africa.”
Ms. Kelly said yes, that’s why we’re sending troops. But why can’t we do that and have a travel ban?
“If it spreads more in Africa, it’s going to be more of a risk to us here. Our only goal is protecting Americans—that’s our mission. We do that by protecting people here and by stopping threats abroad. That protects Americans.”
Dr. Frieden’s logic was a bit of a heart-stopper. In fact his responses were more non sequiturs than answers. We cannot ban people at high risk of Ebola from entering the U.S. because people in West Africa have Ebola, and we don’t want it to spread. Huh?
In testimony before Congress Thursday, Dr. Frieden was not much more straightforward. His answers often sound like filibusters: long, rolling paragraphs of benign assertion, advertising slogans—“We know how to stop Ebola,” “Our focus is protecting people”—occasionally extraneous data, and testimony to the excellence of our health-care professionals.
It is my impression that everyone who speaks for the government on this issue has been instructed to imagine his audience as anxious children. It feels like how the pediatrician talks to the child, not the parents. It’s as if they’ve been told: “Talk, talk, talk, but don’t say anything. Clarity is the enemy.”
The language of government now is word-spew.
Dr. Frieden did not explain his or the government’s thinking on the reasons for opposition to a travel ban. On the other hand, he noted that the government will consider all options in stopping the virus from spreading here, so perhaps that marks the beginning of a possible concession.
It is one thing that Dr. Frieden, and those who are presumably making the big decisions, have been so far incapable of making a believable and compelling case for not instituting a ban. A separate issue is how poor a decision it is. To call it childish would be unfair to children. In fact, if you had a group of 11-year-olds, they would surely have a superior answer to the question: “Sick people are coming through the door of the house, and we are not sure how to make them well. Meanwhile they are starting to make us sick, too. What is the first thing to do?”
The children would reply: “Close the door.” One would add: “Just for a while, while you figure out how to treat everyone getting sick.” Another might say: “And keep going outside the door in protective clothing with medical help.” Eleven-year-olds would get this one right without a lot of struggle.
If we don’t momentarily close the door to citizens of the affected nations, it is certain that more cases will come into the U.S. It is hard to see how that helps anyone. Closing the door would be no guarantee of safety—nothing is guaranteed, and the world is porous. But it would reduce risk and likelihood, which itself is worthwhile.
Africa, by the way, seems to understand this. The Associated Press on Thursday reported the continent’s health-care officials had limited the threat to only five countries with the help of border controls, travel restrictions, and aggressive and sophisticated tracking.
All of which returns me to my thoughts the past few weeks. Back then I’d hear the official wordage that doesn’t amount to a logical thought, and the unspoken air of “We don’t want to panic you savages,” and I’d look at various public officials and muse: “Who do you think you are?”
Now I think, “Who do they think we are?”
Does the government think if America is made to feel safer, she will forget the needs of the Ebola nations? But Americans, more than anyone else, are the volunteers, altruists and in a few cases saints who go to the Ebola nations to help. And they were doing it long before the Western media was talking about the disease, and long before America was experiencing it.
At the Ebola hearings Thursday, Rep. Henry Waxman (D., Calif.) said, I guess to the American people: “Don’t panic.” No one’s panicking—except perhaps the administration, which might explain its decisions.
Is it always the most frightened people who run around telling others to calm down?
This week the president canceled a fundraiser and returned to the White House to deal with the crisis. He made a statement and came across as about three days behind the story—“rapid response teams” and so forth. It reminded some people of the statement in July, during another crisis, of the president’s communications director, who said that when a president rushes back to Washington, it “can have the unintended consequence of unduly alarming the American people.” Yes, we’re such sissies. Actually, when Mr. Obama eschews a fundraiser to go to his office to deal with a public problem we are not scared, only surprised.
But again, who do they think we are? You gather they see us as poor, panic-stricken people who want a travel ban because we’re beside ourselves with fear and loathing. Instead of practical, realistic people who are way ahead of our government.
Klain’s early experience on Capitol Hill included serving as Legislative Director for U.S. RepresentativeEd Markey. From 1989 to 1992, he served as Chief Counsel to the U.S. Senate Committee on the Judiciary, overseeing the legal staff’s work on matters of constitutional law, criminal law, antitrust law, and Supreme Court nominations. In 1995, Senator Tom Daschle appointed him the Staff Director of the Senate Democratic Leadership Committee.
Clinton administration
Klain joined the Clinton-Gore campaign in 1992. He ultimately was involved in both of Bill Clinton‘s campaigns, oversaw Clinton’s judicial nominations, and was General Counsel to Al Gore’s recount committee in the 2000 election aftermath. Some published reports have given him credit for Clinton’s “100,000 cops” proposal during the 1992 campaign; at a minimum, he worked closely with Clinton aide Bruce Reed in formulating it. In the White House, he was Associate Counsel to the President, directing judicial selection efforts, and led the team that won confirmation of Supreme Court Associate Justice Ruth Bader Ginsburg. Klain left the judicial selection role in 1994 to become Chief of Staff and Counselor to Attorney General Janet Reno. In 1995, he became Assistant to the President, and Chief of Staff and Counselor to Al Gore.
Gore campaign
During Klain’s tenure as Gore’s Chief of Staff, Gore consolidated his position as the likely Democratic nominee in 2000. Still, Klain was seen as too loyal to Clinton by some longtime Gore advisors. Feuding broke out between Clinton and Gore loyalists in the White House in 1999, and Klain was ousted by Gore campaign chairmanTony Coelho in August of that year. In October 1999, he joined the Washington, D.C. office of the law firm of O’Melveny & Myers. A year later, Klain returned to the Gore campaign, once Coelho was replaced by William M. Daley. Daley hired Klain for a senior position in the Gore campaign and then named him General Counsel of Gore’s Recount Committee.
Legal career
In 1994, Time named Klain one of the “50 most promising leaders in America” under the age of 40. In 1999, Washingtonian magazine named him the top lawyer in Washington under the age of 40, and the American Bar Association’s Barrister magazine named him one of the top 20 young lawyers nationwide. The National Law Journal named him one of its Lawyers of the Year for 2000.
Lobbying
Klain helped Fannie Mae overcome “regulatory issues”.[8]Lobbying on “regulatory issues concerning Fannie Mae” in 2004, as disclosure forms indicate Klain did, involved convincing Congress and Fannie Mae’s regulators that Fannie Mae wasn’t doing anything dangerous, and wasn’t exposing taxpayers to risk. In other words, Ron Klain got paid to help fuel the housing bubble up until a couple of years before it popped.
2004-2008
During the 2004 Presidential campaign, Klain worked as an adviser to Wesley Clark in the early primaries. Later, during the General Election, Klain was heavily involved behind the scenes in John Kerry‘s campaign and is widely credited for his role in preparing Senator Kerry for a strong performance in the debates against President George W. Bush, which gave Kerry a significant boost in the polls.[9] He then acted as an informal adviser to Evan Bayh, who is from Klain’s home state of Indiana. Klain has also commented on matters of law and policy on televised programs such as the Today Show, Good Morning America, Nightline, Capital Report,NewsHour with Jim Lehrer, and Crossfire.
In 2005, Klain left his partnership at O’Melveny & Myers to serve as Executive Vice President and General Counsel of a new investment firm, Revolution LLC, launched by AOL co-founder Steve Case.[citation needed]
Klain was mentioned as a possible replacement for White House Chief of Staff Rahm Emanuel,[12] but opted to leave the White House for a position in the private sector in January 2011.[2]
Klain apparently signed off on President Obama’s support of a $535 million loan guarantee for now-defunct solar-panel company Solyndra. Despite concerns about whether the company was viable, Klain approved an Obama visit, stating, “The reality is that if POTUS visited 10 such places over the next 10 months, probably a few will be belly-up by election day 2012.”[13]
Dr. Lurie is the Assistant Secretary for Preparedness and Response (ASPR) at the US Department of Health and Human Services (HHS).
The mission of her office is to lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters, ranging from hurricanes to bioterrorism.
Dr. Lurie was previously Senior Natural Scientist and the Paul O’ Neill Alcoa Professor of Health Policy at the RAND Corporation. There she directed RAND’s public health and preparedness work as well as RAND’s Center for Population Health and Health Disparities. She also served as Principal Deputy Assistant Secretary of Health in the US Department of Health and Human Services; in state government, as Medical Advisor to the Commissioner at the Minnesota Department of Health; and in academia, as Professor in the University of Minnesota Schools of Medicine and Public Health. Dr. Lurie has a long history in the health services research field, primarily in the areas of access to and quality of care, mental health, prevention, public health infrastructure and preparedness and health disparities.
Dr. Lurie attended college and medical school at the University of Pennsylvania, and completed her residency and MSPH at UCLA, where she was also a Robert Wood Johnson Foundation Clinical Scholar. She is the recipient of numerous awards, and is a member of the Institute of Medicine.
Finally, Dr. Lurie continues to practice clinical medicine in the health care safety net in Washington, DC. She has three sons.
Nicole Lurie
From Wikipedia, the free encyclopedia
[hide]This article has multiple issues. Please help improve it or discuss these issues on the talk page.
The Assistant Secretary for Preparedness and Response serves as the Secretary’s principal advisor on matters related to bioterrorism and other public health emergencies. The ASPR also coordinates interagency activities between HHS, other Federal departments, agencies, and offices, and State and local officials responsible for emergency preparedness and the protection of the civilian population from acts of bioterrorism and other public health emergencies.[2] The mission of her office is to lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters. Dr. Lurie was nominated to the position by President Obama on May 12, 2009[3] and her confirmation by the U.S. Senate[4] was announced by HHS Secretary Kathleen Sebelius on July 10, 2009.[5]
Dr. Lurie has served as the Senior Natural Scientist and the Paul O’ Neill Alcoa Professor of Health Policy at the RAND Corporation.[7] There she directed RAND’s public health and preparedness work as well as RAND’s Center for Population Health and Health Disparities. She has previously served in federal government, as Principal Deputy Assistant Secretary of Health in the US Department of Health and Human Services; in state government, as Medical Advisor to the Commissioner at the Minnesota Department of Health; and in academia, as Professor in the University of Minnesota School of Medicine and the University of Minnesota School of Public Health. Dr. Lurie has a long history in the health services research field, primarily in the areas of access to and quality of care, managed care, mental health, prevention, public health infrastructure and preparedness and health disparities.
Lurie has served as the Senior Editor for Health Services Research and has served on editorial boards and as a reviewer for numerous journals. She has served on the council and was President of the Society of General Internal Medicine,[8] and on the board of directors for Academy Health, and has served on multiple other national committees.
Story 1: Obama Claims Ebola Virus Not Airborne — Why are The Two Confirmed Cases of Ebola in Dallas Being Sent To a Bio-Safety Level 4 Hospital Bed in A Biocontainment Center — Dr. Nicole Lurie, “The Ebola Czar” Missing In Action — CDC Director Opposes Travel Ban On West African — Videos
BioContainment Unit at The Nebraska Medical Center
The United States Centers for Disease Control commissioned The Nebraska Medical Center biocontainment unit in 2005. It was designed to provide the first line of treatment for people affected by bio terrorism or extremely infectious naturally occurring diseases. It’s the only non-governmental facility of its kind in the U.S.
Ebola Update – The Nebraska Medical Center
Dr. Phil Smith and Dr. Mark Rupp discuss the improving condition of the patient being treated for the Ebola virus at The Nebraska Medical Center. They also answer questions about what may have happened to the health care worker in Dallas who now appears to have Ebola. This video is from a live Ustream broadcast October 12, 2014.
Activation- A Nebraska Medical Center Biocontainment Unit Story
Dr. Sacra’s Tunnel Walk – The Nebraska Medical Center
Dr. Rick Sacra gets an official Nebraska sendoff from staff members who cared for him at The Nebraska Medical Center. Dr. Sacra spent three weeks in the hospital’s Biocontainment Unit being treated for the Ebola virus. He was the third American health care worker to be treated for the virus after contracting it treating patients in West Africa.
NEIDL: Biosafety Level 4
MWV Episode 68 – Threading the NEIDL: TWiV Goes Inside a BSL-4
In the Hot Zone with Virus X – Richard Preston
Elbows-Deep in Ebola Virus – Richard Preston
The Hot Zone” author Richard Preston tells the story of a U.S. Army Lt. Colonel’s life-threatening experience while researching a strain of deadly Ebola virus.
—–
Richard Preston talks about Panic in Level 4: Canibals, Killer Viruses, and Other Journeys to the Edge of Science. These dramatic accounts, all updated since appearing in The New Yorker, are true tales, taking readers on a journey to military labs, hospitals, and jungles around the world, revealing frightening forces and constructive discoveries that are reordering our world – Book Passage
Richard Preston is the author of seven books, including The Hot Zone, The Cobra Event and The Demon in the Freezer, which are his “Dark Biology” series.
Preston is a regular contributor to The New Yorker. His books have been translated into more than 30 languages, and he has won numerous awards, including the American Institute of Physics Award and the National Magazine Award.
Preston is the only non-medical professional ever to receive the Centers for Disease Control’s Champion of Prevention Award for public health.
The Ebola virus The Search for a Cure BBC Full Documentary 2014
Beating the world’s deadliest viral villains
Ebola : Inside the Deadly Outbreak (Documentary 2014)
Ebola: The world’s most dangerous Virus (full documentary)
Ebola – The Truth About the Outbreak (Documentary)
WATCH: CDC Director Dr. Frieden Grilled over Travel Ban at House Ebola Hearing
WATCH: Megyn Kelly Goes Head to Head with CDC Director over Ebola in America
Dr. Nicole Lurie – HHS Assistant Secretary for Preparedness & Response
“I have responsibility for getting the nation prepared for public health emergencies—whether naturally occurring disasters or man-made, as well as for helping it respond and recover. It’s a pretty significant undertaking.”
Dr. Lurie is Assistant Secretary for Preparedness and Response at the US Department of Health and Human Services at HHS. Prior to that, she was Senior Natural Scientist and the Paul O Neill Alcoa Professor of Health Policy at the RAND Corporation. There she directed RANDs public health and preparedness work as well as RANDs Center for Population Health and Health Disparities.
Ebola Czar hides away in bunker — Dr. Nicole Lurie
John McCain: U.S. Needs an Ebola Czar
Ebola Czar pissed away a billion dollars on kick-backs — Dr. Nicole Lurie
Dr. Nicole Lurie’s Ebola death squads — urr — temporary morgues
Experts: Ebola Could Go Airborne, Kill Millions
Expert Doctor says CDC is lying about Ebola virus
Ebola strain appears to be different
The Structural Basis of Ebola Viral Pathogenesis
Obama administration failed to implement all of the CDC’s advice to prevent an Ebola outbreak
The Centers for Disease Control told the incoming Obama administration in 2008 that it should establish 18 regional disease detection centers around the world to adequately safeguard the U.S. from emerging health threats like Ebola, according to an agency memo.
But six years later, as the government struggles to contain the fallout from a deadly Ebola outbreak at home and abroad, the CDC still has only 10 centers — and none of them operates in the western Africa region hardest hit by the deadly virus.
“The existing centers have already proven their effectiveness and impact on detecting and responding to outbreaks including avian influenza, aflatoxin poisoning, Rift Valley fever, Ebola and Marburg virus outbreaks,” the CDC said in its memo to the Obama transition team, which The Washington Times obtained through a Freedom of Information Act request.
At the time, the CDC had five centers set up, and has only added five more of the 13 the agency had proposed “to complete the network and properly protect the nation.”
The memo sheds new light on the problems dealing with the current Ebola crisis, which intensified with the revelations Wednesday that a second Texas nurse had tested positive for the disease and President Obama used a White House Cabinet meeting to promise a “more aggressive” federal response to the threat.
The CDC’s plan outlined in the transition memo was based on the notion that the U.S. shouldn’t wait for a disease to enter the country but rather monitor threats in hot spots overseas to try to help local public health authorities control outbreaks before then.
The CDC didn’t respond to messages seeking comment on its plans Wednesday.
On its Web page, the agency said it has eight regional centers running, with another two in development.
Aside from detecting and monitoring diseases, the centers also provide education to local public health authorities. Though the CDC operates three response centers in Africa — in Kenya, Egypt and South Africa — none of those are based in the western parts of the continent that have seen major Ebola outbreaks this year.
News on Wednesday that another patient in the U.S. — a second health care worker who treated an Ebola patient in Texas — may be infected prompted calls for tightened travel restrictions and at least a temporary travel ban for Liberia, Guinea and Sierra Leone, including one from House Speaker John A. Boehner, Ohio Republican.
The administration has so far rejected those calls, with health officials saying they fear the bans could prevent them from getting aid workers and medical assistance to and from Africa.
Meanwhile, the fight over funding for anti-Ebola efforts has turned political.
Fights over funding
Five Democratic House members on Wednesday called for hearings into budget cuts at the National Institutes of Health and CDC.
The lawmakers said NIH has lost $1.2 billion in funding over the last four years and that a CDC program that supports public workers was slashed 16 percent during the past four years, while a hospital preparedness program lost 44 percent of its funding.
“The CDC and the NIH are already working to combat the spread of Ebola,” said Rep. Michael M. Honda, California Democrat. “In light of recent tragic developments in Texas, and in the interests of ensuring public safety and transparency, we need an update from these agencies so we can ensure they have the proper funding to protect patients, health care workers and the public at large.”
As the deadly virus continues to spread, the CDC has sent dozens of disease control experts into western Africa. In a recent budget document, the agency also has said it’s seeking an extra $45 million for global health security “to accelerate progress toward a world safe and secure from infectious disease threats.”
But the agency’s own memo to the president’s transition team highlighted the need for beefed-up infectious disease detection and other public health efforts overseas. It also reflects funding concerns during the George W. Bush administration.
“Our investment is modest,” the CDC memo stated, “but our capacity in most critical areas has been eroded by budget attrition and increases in the cost of science, travel and infrastructure support in recent years.”
The comments were included in the appendix to the agency’s 128-page briefing memo to the transition team. That same portion of the report had been sent in 2007 to a House appropriations subcommittee overseeing CDC funding, according to the transition memo.
The memo also stated that “core funding” for noninfluenza infectious diseases was lacking, “leaving us many millions behind where we were five years ago when adjusted for inflation.”
“Programs for rabies, rotavirus, food safety, special pathogens like Ebola virus and many others need immediate support if they are to sustain their baseline capabilities.”
The White House and CDC have both cited the regional response centers in recent weeks as an example of the administration’s Ebola response.
Neither the White House nor the Department of Health and Human Services, which oversees the CDC, responded to messages about the recommendation for 18 regional centers.
Senate Health, Education, Labor and Pensions Committee Chairman Tom Harkin, Iowa Democrat, said in a recent floor speech that he’s worked for years to secure more funding for CDC disease detection centers overseas.
“We must stop chasing diseases after the fact and start building public health systems capable of detecting and stopping diseases before they cross borders,” Mr. Harkin said.
The transition memo sounded a similar warning to Mr. Obama’s team as the president prepared to take power in late 2008: “Our nation’s preparedness has greatly benefited from government investments in terrorism and pandemic influenza preparedness, but recent events illustrated that vulnerabilities remain.”
(Via The Federalist) […] See, in 2004, Congress passed The Project Bioshield Act. The text of that legislation authorized up to $5,593,000,000 in new spending by NIH for the purpose of purchasing vaccines that would be used in the event of a bioterrorist attack. A major part of the plan was to allow stockpiling and distribution of vaccines.
Just two years later, Congress passed the Pandemic and All-Hazards Preparedness Act, which created a new assistant secretary for preparedness and response to oversee medical efforts and called for a National Health Security Strategy. The Act established Biomedical Advanced Research and Development Authority as the focal point within HHS for medical efforts to protect the American civilian population against naturally occurring threats to public health. It specifically says this authority was established to give “an integrated, systematic approach to the development and purchase of the necessary vaccines, drugs, therapies, and diagnostic tools for public health medical emergencies.”
If you look at any of the information about these pieces of legislation or the office and authorities that were created, this brand new expansion of the federal government was sold to us specifically as a means to fight public health threats like Ebola. That was the entire point of why the office and authorities were created.
In fact, when Sen. Bob Casey was asked if he agreed the U.S. needed an Ebola czar, which some legislators are demanding, he responded: “I don’t, because under the bill we have such a person in HHS already.”
[…] So, we have an office for public health threat preparedness and response. And one of HHS’ eight assistant secretaries is the assistant secretary for preparedness and response, whose job it is to “lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters, ranging from hurricanes to bioterrorism.”
In the video below, the woman who heads that office, Dr. Nicole Lurie, explains that the responsibilities of her office are “to help our country prepare for, respond to and recover from public health threats.” She says her major priority is to help the country prepare for emergencies and to “have the countermeasures—the medicines or vaccines that people might need to use in a public health emergency. So a large part of my office also is responsible for developing those countermeasures.” (read more)
Or, as National Journal rather glowingly puts it, “Lurie’s job is to plan for the unthinkable. A global flu pandemic? She has a plan. A bioterror attack? She’s on it. Massive earthquake? Yep. Her responsibilities as assistant secretary span public health, global health, and homeland security.” A profile of Lurie quoted her as saying, “I have responsibility for getting the nation prepared for public health emergencies—whether naturally occurring disasters or man-made, as well as for helping it respond and recover. It’s a pretty significant undertaking.” Still another refers to her as “the highest-ranking federal official in charge of preparing the nation to face such health crises as earthquakes, hurricanes, terrorist attacks, and pandemic influenza.”
Now, you might be wondering why the person in charge of all this is a name you’re not familiar with. Apart from a discussion of Casey’s comments on how we don’t need an Ebola czar because we already have one, a Google News search for Lurie’s name at the time of writing brings up nothing in the last hour, the last 24 hours, not even the last week! You have to get back to mid-September for a few brief mentions of her name in minor publications. Not a single one of those links is confidence building.
So why has the top official for public health threats been sidelined in the midst of the Ebola crisis? Only the not-known-for-transparency Obama administration knows for sure. But maybe taxpayers and voters should force Congress to do a better job with its oversight rather than get away with the far easier passing of legislation that grants additional funds before finding out what we got for all that money we allocated to this task over the last decade. And then maybe taxpayers should begin to puzzle out whether their really bad return on tax investment dollars is related to some sort of inherent problem with the administrative state.
The Ron Perelman Scandal
There are a few interesting things about the scandal Lurie was embroiled in years ago. You can—and should—read all about it in the Los Angeles Times‘ excellent front-page expose from November 2011, headlined: “Cost, need questioned in $433-million smallpox drug deal: A company controlled by a longtime political donor gets a no-bid contract to supply an experimental remedy for a threat that may not exist.” This Forbespiece is also interesting.
The donor is billionaire Ron Perelman, who was controlling shareholder of Siga. He’s a huge Democratic donor but he also gets Republicans to play for his team, of course. Siga was under scrutiny even back in October 2010 when The Huffington Post reported that it had named labor leader Andy Stern to its board and “compensated him with stock options that would become dramatically more valuable if the company managed to win the contract it sought with HHS—an agency where Stern has deep connections, having helped lead the year-plus fight for health care reform as then head of the Service Employees International Union.”
The award was controversial from almost every angle—including disputes about need, efficacy, and extremely high costs. There were also complaints about awarding a company of its size and structure a small business award as well as the negotiations involved in granting the award. It was so controversial that even Democrats in tight election races were calling for investigations.
Last month, Siga filed for bankruptcy after it was found liable for breaching a licensing contract. The drug it’s been trying to develop, which was projected to have limited utility, has not really panned out—yet the feds have continued to give valuable funds to the company even though the law would permit them to recoup some of their costs or to simply stop any further funding.
The Los Angeles Times revealed that, during the fight over the grant, Lurie wrote to Siga’s chief executive, Dr. Eric A. Rose, to tell him that someone new would be taking over the negotiations with the company. She wrote, “I trust this will be satisfactory to you.” Later she denied that she’d had any contact with Rose regarding the contract, saying such contact would have been inappropriate.
The company that most fought the peculiar sole-source contract award to Siga was Chimerix, which argued that its drug had far more promise than Siga’s. And, in fact, Chimerix’s Brincidofovir is an antiviral medication being developed for treatment of smallpox but also Ebola and adenovirus. In animal trials, it’s shown some success against adenoviruses, smallpox, and herpes—and preliminary tests show some promise against Ebola. On Oct. 6, the FDA authorized its use for some Ebola patients.
It was given to Ebola patient Thomas Eric Duncan, who died, and Ashoka Mukpo, who doctors said had improved. Mukpo even tweeted that he was on the road to recovery.
Money, or rather the lack of it, is a big part of the problem. NIH’s purchasing power is down 23 percent from what it was a decade ago, and its budget has remained almost static. In fiscal year 2004, the agency’s budget was $28.03 billion. In FY 2013, it was $29.31 billion—barely a change, even before adjusting for inflation.
Indeed. The Progressive belief that a powerful government can stop all calamity is misguided. In the last 10 years we passed multiple pieces of legislation to create funding streams, offices, and management authorities precisely for this moment. That we have nothing to show for it is not good reason to put even more faith in government without learning anything from our repeated mistakes. Responding to the missing Ebola Czar and her office’s corruption by throwing still more money, more management changes, and more bureaucratic complexity in her general direction is madness.
Tracking a Serial Killer: Could Ebola Mutate to Become More Deadly?
Why we need to terminate Ebola 2014 before the virus learns too much about us.
bY David Quammen
Forty years ago, Ebola was just the name of a river. It was a small waterway of no particularly sinister character that flowed through northern Zaire, not far from the village hospital where the first known outbreak of a new viral disease had been centered. That river gave its name to the new virus, and now “Ebola” is a global byword for ugly death, misery, and fear of contagion.
The 2014 epidemic of Ebola virus disease in West Africa is unprecedented in scope, and much attention has been focused, rightly, on how it has gotten so badly out of control.
Behind that question are three others, less obvious, more complicated, and crucial to seeing Ebola in a broader context: Where did the virus come from? Where is it going? What’s next? We do well to consider these questions even as we react to the daily headlines, urge our leaders to take more deeply committed action, and support the organizations (such as Doctors Without Borders) that are fighting the epidemic so courageously in West Africa.
Where Did It Come From?
The outbreak began in early December, in a village called Meliandou, southeastern Guinea, not far from the borders with both Liberia and Sierra Leone. The first known case was a two-year-old child who died, after fever and vomiting and passing black stool, on December 6. The child’s mother died a week later, then a sister and a grandmother, all with symptoms that included fever, vomiting, and diarrhea. Then, by way of caregiving visits or attendance at funerals, the outbreak spread to other villages.
It wasn’t until March, three months later, that local officials alerted the Guinean Ministry of Health about these clusters of a strange, lethal disease in the countryside. By then, human-to-human transmission had started to multiply the case count. But tracing linked cases raises the question of ultimate origin. How did that first child get sick?
Ebola virus is a zoonosis, meaning an animal infection transmissible to humans. The animal in which a zoonosis lives its customary existence, discreetly, over the long term, and without causing symptoms, is called a reservoir host. The reservoir host of Ebola virus is still unknown—even after 38 years of efforts to identify it, since the original 1976 outbreak—although one or more kinds of fruit bat, including the hammer-headed bat, are suspects. There are hammer-headed bats in southeastern Guinea. It’s possible that somebody killed one for food and brought it to Meliandou, where the child became infected either by direct contact with the bat or by virus passed on the hands of an adult.
Why are these facts and suppositions significant? Because they remind us that Ebola virus abides endemically in the forests of equatorial Africa. It will never be eradicated as long as those forests exist, unless the reservoir host itself is eradicated (not recommended) or cured of the viral infection (not likely possible). The virus may retire into its hiding place for years at a time, but eventually it will return, as a result of some disruptive contact by humans with the reservoir host. Then it will spill over into us again. All thinking and planning about how to defend against Ebola virus disease in the future needs to take account of that reality.
Another puzzling fact about origins is that the West Africa epidemic involves a species of ebolavirus (that’s the label for the group, which includes five species) previously known only from outbreaks in the Democratic Republic of the Congo and its close neighbors.
A different species has emerged in Ivory Coast, another West African country, just east of Guinea and Liberia. According to a study published in Science in late August by Stephen K. Gire of Harvard and a long list of co-authors, the virus in West Africa seems to have diverged from its lineage in Central Africa just within the past decade. It somehow leapfrogged over or around the Ivory Coast ebolavirus in order to situate itself in southeastern Guinea. That suggests the unnerving prospect that the Central African ebolavirus (the only one strictly known as Ebola virus) is expanding its range, either by infecting new populations of reservoir hosts or by migrations of those host animals.
One way or another, it has been on the move.
Fruit bats are sold at an outdoor market in Brazzaville, capital of the Republic of the Congo. The reservoir host of Ebola virus is still unknown, but one or more kinds of fruit bat are suspects.
Where Is It Going?
The virus has also traveled within living human bodies. We know that it went from Liberia to Dallas within the late Thomas Eric Duncan, from Liberia to Nigeria by way of the late Patrick Sawyer, and from Sierra Leone to Spain by way of two Spanish missionary priests, both also now deceased, who were evacuated for treatment.
And it has been carried to Omaha, Atlanta, London, Paris, Hamburg, Frankfurt, and Oslo within infected people, mostly health and aid workers brought home to be treated.
But just as worrisome as the virus’s geographic spread is its journey across the evolutionary landscape. Is it mutating in ways that could make it more dangerous to humans? Is there any chance that it might become transmissible through the air, like the flu, the SARS virus, or a common cold?
Although Ebola becoming airborne is the ultimate disease nightmare, that seems to be almost vanishingly improbable, for reasons well put in a recent article in the Washington Post by Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations. What is now a fluid-borne virus attaching itself to cells lining the circulatory system can’t easily change into one that targets the tiny air sacs in the lungs.
“That’s a genetic leap in the realm of science fiction,” Garrett wrote.
The virus probably will not go airborne, but it could conceivably increase its Darwinian fitness in other ways, becoming more subtle and elusive.
The genetic study by Gire and his colleagues (five of whom were dead of Ebola by the time their study appeared) found 341 mutations as of late August, some of which are significant enough to change the bug’s functional identity. The higher the case count in West Africa goes, the more chances for further mutations, and therefore the greater possibility that the virus might adapt somehow to become more transmissible-perhaps by becoming less pathogenic, sickening or killing its victims more slowly and thereby leaving them more time to infect others.
That’s why, the Gire group wrote, we need to stop this thing everywhere as soon as possible. Future spillovers of Ebola are bound to occur, but those freshly emerged strains of the virus, direct from the reservoir host, won’t contain any adaptive mutations that the West Africa strain is acquiring now.
We need to terminate Ebola 2014 before the virus learns too much about us.
Kumba Conde cries after her sister Marie, 14, died from Ebola in Koundony, Guinea, in July 2014. The current outbreak began in December 2013 in southeastern Guinea, not far from the borders with both Liberia and Sierra Leone.
What’s Next?
No one knows, of course, how much worse the epidemic in West Africa will get. The U.S. Centers for Disease Control and Prevention issued a report, in late September, projecting that under the worst-case scenario there could be 1.4 million cases by early next year. The World Health Organization said Tuesday that new cases could rise to 10,000 per week by December, ten times the rate of the previous month. And the World Bank has warned that costs of the epidemic could reach $32.6 billion, which would be an economic catastrophe for the three West African countries that would compound their health catastrophes.
Will the epidemic spread more widely, igniting outbreaks in other parts of the world? We hope not. Will it turn up as additional cases, here and there, among people who have traveled from West Africa unaware, as Thomas Eric Duncan was reportedly unaware, that they were infected before boarding the airplane? Probably.
What’s the best way to limit such occurrences? Rigorous screening at airports, quarantine for travelers who test positive, travel restrictions, or perhaps total bans on commercial flights arriving from Liberia, Guinea, and Sierra Leone-these measures should help. The most important and effective thing we can do, though, is to provide all possible assistance toward ending the outbreak where it began, in West Africa.
The world won’t be free of Ebola 2014 until West Africa is free of it. Even severe restrictions, barring entry to anyone traveling from West Africa, would not make it impossible for the virus to get into America, or Europe, or wherever. To understand why, consider what I call the Nairobi Tabletop Scenario.
Imagine a doctor who departs from Monrovia, the capital of Liberia, feeling fine, on a flight to Nairobi, Kenya’s capital, in East Africa. In transit he begins suffering a headache-nothing terrible yet, just discomfort, but it’s the first hint of Ebola. At the Nairobi airport, in a café, the Liberian doctor coughs onto a table. Five minutes later, an American businessman touches that table. He rubs his eye. He departs to Singapore and spends three days there, in good health, discussing finance for his project in Kenya. Then he flies home to Los Angeles. To the screeners at LAX, he is an American businessman arriving from Singapore, with no history of recent travel in West Africa. But he’s now infected with Ebola, carrying it into the United States.
How do you defend against the Nairobi Tabletop Scenario? By doing everything possible to end the epidemic in West Africa, and thereby to ensure that the Liberian doctor is healthy when he visits Nairobi.
Our safety against the menace of killer viruses can never be an absolute safety. There are too many of them, lurking within reservoir hosts amid distant forests or closer to home-viruses such as Nipah in Bangladesh, Marburg in Uganda, Lassa in West Africa, Sin Nombre virus in the American West, all the new influenzas coming out of southeastern Asia, plus many others that haven’t yet been identified and named.
And there are too many of us humans, sharing the landscape with the reservoir hosts and with one another. We are too interconnected by air travel and transport. Viruses are simple organisms but well-adapted to the modern world. This year it’s Ebola, devastating and scary. Next year it will be something else.
Story 1: Breaking News — Third Confirmed Case of Ebola in Dallas, Texas, Airborne Ebola Spreading Through Tiny Aerosolized Droplets in Sneezes and Coughs — Time To Send Ebola Patients to A Biosafety Level 4 Safety Hospitals with A Total of 19 Beds — Videos
“We shall not grow wiser before we learn that much that we have done was very foolish.”
Friedrich August von Hayek
Obama Calls for CDC ‘SWAT’ Team for Ebola Virus
Response Team to Be Sent for Any Ebola Case: Obama
Experts: Ebola Could Go Airborne, Kill Millions
Expert Doctor says CDC is lying about Ebola virus
Ebola strain appears to be different
Second Health Care Worker Tests Positive For Ebola In Texas
Dallas Mayor: ‘It May Get Worse Before it Gets Better’
Texas officials confirm second healthcare worker has Ebola
CDC: Ebola patient flew on plane before diagnosis
CDC Set To Slow Large Ebola Outbreak by Placing Doctors At Risk
BioContainment Unit at The Nebraska Medical Center
USAMRIID The US Army Medical Research Institute of Infectious Disease
USAMRIID Overview
Activation- A Nebraska Medical Center Biocontainment Unit Story
US Army: Ebola like FLU needs Winter Weather to go AIRBORNE
Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable
Aerosolizing ONE DROP of EBOLA = 1/2 MILLION DEAD
Ebola – The Truth About the Outbreak (Documentary)
Why Do Viruses Kill
MicroKillers: Super Flu
The Influenza Pandemic of 1918
We Heard the Bells: The Influenza of 1918 (full documentary)
In 1918-1919, the worst flu in recorded history killed an estimated 50 million people worldwide. The U.S. death toll was 675,000 – five times the number of U.S. soldiers killed in World War I. Where did the 1918 flu come from? Why was it so lethal? What did we learn?
RED ALERT: TOP GENERAL WARNS EBOLA WILL NOT STAY IN WEST AFRICA!!!!
Dallas Mayor: ‘It May Get Worse Before it Gets Better’
“There are two things that I harken back to this. The only way that we are going to beat this is person by person, moment by moment, detail by detail. We have those protocols in place, the city and county, working closely with the CDC and the hospital. The second is we want to minimize rumors and maximize facts. We want to deal with facts, not fear. And I continue to believe that while Dallas is anxious about this and with this news this morning, the anxiety level goes up a level, we are not fearful and I’m pleased and proud of the citizens that I talk to day in and day out knowing that there is hope if we take care and do what is right in these details. It may get worse before it gets better. But it will get better.”
The comments were given at a news conference in Dallas this morning announcing that another hospital worker in Dallas has been diagnosed with Ebola.
Nurses’ Union: Ebola Patient Left In Open Area Of ER For Hours
A Liberian Ebola patient was left in an open area of a Dallas emergency room for hours, and nurses treating him worked without proper protective gear and faced constantly changing protocols, according to a statement released by the nation’s largest nurses’ union.
Among those nurses was Nina Pham, 26, who has been hospitalized since Friday after catching Ebola while caring for Thomas Eric Duncan, the first person diagnosed with the virus in the U.S. He died last week.
Public-health authorities announced Wednesday that a second Texas Health Presbyterian Hospital health care worker had tested positive for Ebola, raising more questions about whether American hospitals and their staffs are adequately prepared to contain the virus.
The CDC has said some breach of protocol probably sickened Pham, but National Nurses United contends the protocols were either non-existent or changed constantly after Duncan arrived in the emergency room by ambulance on Sept. 28.
Medical records provided to The Associated Press by Duncan’s family show that Pham helped care for him throughout his hospital stay, including the day he arrived in intensive care with diarrhea, abdominal pain, nausea and vomiting, and the day before he died.
When Pham’s mother learned she was caring for Duncan, she tried to reassure her that she would be safe.
Pham told her: “Mom, no. Don’t worry about me,” family friend Christina Tran told The Associated Press.
Duncan’s medical records make numerous mentions of protective gear worn by hospital staff, and Pham herself notes wearing the gear in visits to Duncan’s room. But there is no indication in the records of her first encounter with Duncan, on Sept. 29, that Pham donned any protective gear.
Deborah Burger of National Nurses United, who convened a conference call with reporters to relay what she said were concerns of nurses at the hospital, said they were forced to use medical tape to secure openings in their flimsy garments and worried that their necks and heads were exposed as they cared for Duncan.
RoseAnn DeMoro, executive director of Nurses United, said the statement came from “several” and “a few” nurses, but she refused repeated inquiries to state how many. She said the organization had vetted the claims, and that the nurses cited were in a position to know what had occurred at the hospital. She did not specify whether they were among the nurses caring for Duncan.
The nurses allege that his lab samples were allowed to travel through the hospital’s pneumatic tubes, possibly risking contaminating of the specimen-delivery system. They also said that hazardous waste was allowed to pile up to the ceiling.
Wendell Watson, a Presbyterian spokesman, did not respond to specific claims by the nurses but said the hospital has not received similar complaints.
“Patient and employee safety is our greatest priority, and we take compliance very seriously,” he said in a statement. He said the hospital would “review and respond to any concerns raised by our nurses and all employees.”
The nurses’ statement said they had to “interact with Mr. Duncan with whatever protective equipment was available,” even as he produced “a lot of contagious fluids.” Duncan’s medical records underscore that concern. They also say nurses treating Duncan were also caring for other patients in the hospital and that, in the face of constantly shifting guidelines, they were allowed to follow whichever ones they chose.
When Ebola was suspected but unconfirmed, a doctor wrote that use of disposable shoe covers should also be considered. At that point, by all protocols, shoe covers should have been mandatory to prevent anyone from tracking contagious body fluids around the hospital.
A few days later, however, entries in the hospital charts suggest that protection was improving.
“RN entered room in Tyvek suits, triple gloves, triple boots, and respirator cap in place,” a nurse wrote.
The Presbyterian nurses are not represented by Nurses United or any other union. DeMoro and Burger said the nurses claimed they had been warned by the hospital not to speak to reporters or they would be fired.
The AP has attempted since last week to contact dozens of individuals involved in Duncan’s care. Those who responded to reporters’ inquiries have so far been unwilling to speak.
David R. Wright, deputy regional administrator for the U.S. Centers for Medicare & Medicaid Services, which monitors patient safety and has the authority to withhold federal funding, said his agency is going to want to get all of the information the nurses provided.
“We can’t talk about whether we’re going to investigate or not, but we’d be interested in hearing that information,” he said.
CDC officials did not immediately respond to requests for comment.
Duncan first sought care at the hospital’s ER late on Sept. 25 and was sent home the next morning. He was rushed by ambulance back to the hospital on Sept. 28. Unlike his first visit, mention of his recent arrival from Liberia immediately roused suspicion of an Ebola risk, records show.
The CDC said 76 staff members at the hospital could have been exposed to Duncan after his second ER visit. Another 48 people who may have had contact with him before he was isolated are being monitored. Pham remained hospitalized Tuesday in good condition and said in a statement that she was doing well.
The Rev. Jim Khoi, pastor at Our Lady of Fatima Church in Fort Worth, which Pham’s family attends, said the 2010 Texas Christian University nursing school graduate appeared to be in good spirits when she spoke to her mother via video chat.
Pham’s mother, Ngoc Pham, is “calm,” Khoi said. “She trusts in God. And she asks for prayers.”
CDC: Ebola Patient Traveled By Air With “Low-Grade” Fever
The CDC has announced that the second healthcare worker diagnosed with Ebola — now identified as Amber Joy Vinson of Dallas — traveled by air Oct. 13, with a low-grade fever, a day before she showed up at the hospital reporting symptoms.
The CDC is now reaching out to all passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth. The flight landed at 8:16 p.m. CT.
All 132 passengers on the flight are being asked to call 1 800-CDC INFO (1 800 232-4636). Public health professionals will begin interviewing passengers about the flight Wednesday afternoon.
“Although she (Vinson) did not report any symptoms and she did not meet the fever threshold of 100.4, she did report at that time she took her temperature and found it to be 99.5,” said CDC Director Tom Frieden. Her temperature coupled with the fact that she had been exposed to the virus should have prevented her from getting on the plane, he said. “I don’t think that changes the level of risk of people around her. She did not vomit, she was not bleeding, so the level of risk of people around her would be extremely low.”
Vinson first reported a fever to the hospital on Tuesday (Oct. 14) and was isolated within 90 minutes, according to officials. She did not exhibit symptoms while on the Monday flight, according to crew members. However, the CDC says passenger notification is needed as an “extra level of safety” due to the proximity in time between the flight and the first reported symptoms.
“Those who have exposures to Ebola, she should not have traveled on a commercial airline,” said Dr. Frieden. “The CDC guidance in this setting outlines the need for controlled movement. That can include a charter plane; that can include a car; but it does not include public transport. We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement.”
Frieden specifically noted that the remaining 75 healthcare workers who treated Thomas Duncan at Texas Health Presbyterian Hospital will not be allowed to fly. The CDC will work with local and state officials to accomplish this.
Frontier Airlines is working closely with the CDC to identify and notify all passengers on the flight. The airline also says the plane has been thoroughly cleaned and was removed from service following CDC notification early Wednesday morning.
However, according to Flighttracker, the plane was used for five additional flights on Tuesday before it was removed from service. Those flights include a return flight to Cleveland, Cleveland to Fort Lauderdale–Hollywood International Airport (FLL), FLL to Cleveland, Cleveland to Hartsfield–Jackson Atlanta International Airport (ATL), and ATL to Cleveland.
While in Ohio, Vinson visited relatives, who are employees at Kent State University. The university is now asking Vinson’s three relatives stay off campus and self-monitor per CDC protocol for the next 21 days out of an “abundance of caution.”
“It’s important to note that the patient was not on the Kent State campus,” said Kent State President Beverly Warren. “She stayed with her family at their home in Summit County and did not step foot on our campus. We want to assure our university community that we are taking this information seriously, taking steps to communicate what we know,” said Dr. Angela DeJulius, director of University Health Services at Kent State.
Vinson is a Kent State graduate. She received degrees from there in 2006 and 2008.
Cleveland’s Public Health Director, Toinette Parrilla, said Vinson was visiting in preparation for her wedding. While there, she visited her mother and her fiance.
The latest Ebola diagnosis was announced by the Texas Department of State Health Services early Wednesday morning.
Vinson is the second worker at Presbyterian Hospital to be diagnosed after providing health care to Duncan, the first person to be diagnosed with Ebola in the United States. He died last week.
Medical records provided to The Associated Press by Thomas Eric Duncan’s family show Amber Joy Vinson was actively engaged in caring for Duncan in the days before his death. The records show she inserted catheters, drew blood, and dealt with Duncan’s body fluids.
Dallas Mayor Mike Rawlings addressed the media on Wednesday, saying the patient lives alone and has no pets.
“It may get worse before it gets better,” Rawlings said, “but it will get better.”
Crews worked to decontaminate the common areas of Vinson’s Dallas apartment building Tuesday morning. The apartment unit will be decontaminated by contractors starting early Wednesday afternoon.
The CDC announced that Vinson will be transported to Emory Hospital in Atlanta for further treatment. Two previous American Ebola patients, Dr. Kent Brantly and Nancy Writebol, were treated at Emory and were the first Ebola patients to be treated in the United States. They were released in August.
Nina Pham was diagnosed with the virus over the weekend and remains isolated in good condition. Pham’s dog — a Cavalier King Charles Spaniel named Bentley — has been taken into custody and is being cared for at an undisclosed location.
Frontier Airlines released the following statement:
“At approximately 1:00 a.m. MT on October 15, Frontier was notified by the CDC that a customer traveling on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on Oct. 13 has since tested positive for the Ebola virus. The flight landed in Dallas/Fort Worth at 8:16 p.m. local and remained overnight at the airport having completed its flying for the day at which point the aircraft received a thorough cleaning per our normal procedures which is consistent with CDC guidelines prior to returning to service the next day. It was also cleaned again in Cleveland last night. Previously the customer had traveled from Dallas Fort Worth to Cleveland on Frontier flight 1142 on October 10.
Customer exhibited no symptoms or sign of illness while on flight 1143, according to the crew. Frontier responded immediately upon notification from the CDC by removing the aircraft from service and is working closely with CDC to identify and contact customers who may traveled on flight 1143.
Customers who may have traveled on either flight should contact CDC at 1 800 CDC-INFO.
The safety and security of our customers and employees is our primary concern. Frontier will continue to work closely with CDC and other governmental agencies to ensure proper protocols and procedures are being followed.”
Frontier jet made 5 flights before taken out of service in Ebola scare
The Frontier Airlines jet that carried a Dallas healthcare worker diagnosed with Ebola made five additional flights after her trip before it was taken out of service, according to a flight-monitoring website.
Denver-based Frontier said in a statement that it grounded the plane immediately after the carrier was notified late Tuesday night by the Centers for Disease Control and Prevention about the Ebola patient.
Ebola patient flew day before symptoms surfaced
Amber Joy Vinson of Dallas, traveled by air on Oct. 13, the day before she first reported symptoms.
Flight 1143, on which the woman flew from Cleveland to Dallas/Fort Worth, was the last trip of the day Monday for the Airbus A320. But Tuesday morning the plane was flown back to Cleveland and then to Fort Lauderdale, Fla., back to Cleveland and then to Atlanta and finally back to Cleveland again, according to Daniel Baker, chief executive of the flight-monitoring site Flightaware.com.
He said his data did not include any passenger manifests, so he could not tell how many total passengers flew on the plane Tuesday.
The airline said it is working with the CDC to contact all 132 passengers on the Monday flight that carried the Ebola patient.
Frontier could not be reached to confirm the FlightAware data, and it was unclear if passengers on the additional flights were being contacted.
The passenger “exhibited no symptoms or sign of illness while on Flight 1143, according to the crew,” Frontier said.
The plane went through a routine but “thorough” cleaning Monday night, Frontier said. Airline industry experts said routine overnight cleaning includes wiping down tray tables, vacuuming carpet and disinfecting restrooms.
The healthcare worker also had flown to Cleveland from Dallas three days earlier on Frontier Flight 1142, the airline reported.
In response to the news that another Ebola patient flew on a commercial flight, the union that represents 60,000 flight attendants on 19 airlines is asking the CDC to monitor and care for the four flight attendants who were on flight from Cleveland to Dallas/Fort Worth.
cComments
whats it going to take to close the border to people from africa? 10 dead? 100 dead? 1000 dead? we know obumma doesnt give a flying fluke about the american citizens, but isn’t there someone in the government with an ounce of brains? or is this part of obumma’s scheme to declare martial law?…
The Assn. of Flight Attendants “will continue to press that crew members are regularly monitored and provided with any additional resources that may be required,” the group said.
The Ebola scare prompted the union last week to call for better measures to protect flight attendants from exposure to the deadly virus.
The group’s international president, Sara Nelson, suggested that flight attendants are being asked to do too much in the fight against Ebola.
“We are not, however, professional healthcare providers and our members have neither the extensive training nor the specialized personal protective equipment required for handling an Ebola patient,” she said in a statement.
Earlier this month, United Airlines was rushing to contact passengers who flew on two flights that carried a Liberian man infected with Ebola from Brussels to Washington, D.C., and then to Dallas.
The Ebola-stricken healthcare worker who flew on Frontier had been treating the Liberian man, Thomas Eric Duncan, who has since died.
Airline-industry stock prices have taken a beating in recent weeks, with some analysts blaming the Ebola scare.
On Wednesday, stocks of Delta Air Lines and American Airlines fell more than 6% in early trading before partially recovering. With less than 90 minutes remaining in the regular trading session, the two stocks were each down about 2% from Tuesday’s closes. Frontier is privately held.
There are only 19 level 4 bio-containment beds in the whole of the United States…and four in the UK
Liz Bennett
The UK is well set for an Ebola outbreak (sarcasm alert) We have TWO isolation units, but one is getting ‘redeveloped’ so it’s not available right now. Called High Security Infectious Diseases Units there are two in the country, each capable of taking two patients. One is at The Royal Free Hospital in Hampstead North London, the other, the one getting a bit of a make-over, is at The Royal Victoria Infirmary in Newcastle, up in the north-east of England.
Four level 4 bio-containment beds between 69,000,000 people
In the US there are 4 units geared up to handle Ebola. The National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, has 3 beds. Nebraska Medical Center, Omaha, has 10 beds. Emory Hospital, Atlanta has 3 beds and St Patricks Hospital, Missoula has 3 beds (source)
19 level four biocontainment beds for 317,000,000 people
I think we just found out why the government(s) are under-playing the situation. They simply do not have the facilities to cope with even a small outbreak. They are, in fact in exactly the same position as the dirt-poor hospitals in West Africa…there are not enough facilities to stop the spread of the disease if it gets out. The quality of care is better, but the availability of containment most likely isn’t.
I am sure ‘regular’ isolation units will be pressed into use but they are not designed to handle level 4 biohazards, they are nowhere near as secure medically speaking, as biocontainment units.
A couple of days ago I explained how exponential spread works. You can read that article here if you like. As a quick recap. Once a disease is at the point where every carrier infects 2 more people,(exponential spread) it will continue until it:
A) runs out of hosts
B) is stopped by medical science or
C) mutates into something less harmful.
What follows will show you how woefully inadequately our governments have prepared for something as lethal as Ebola.
In the flu pandemic of 1918-1920 28% of Americans were infected with the disease…try to remember I am talking numbers here not HOW disease spreads or any medical similarities between diseases, 625,000 Americans lost their lives out of some 29,400,000 infections. The population of the United States at that time was 105,000,000 people. (source)
Fast forward to today. If that flu pandemic had hit the United States in 2014, when the population stands at 317,000,000 people 88,760,000 people would have been infected and 2,130,240 of them would have died.
Now, let’s try this with Ebola. I have picked Liberia just because it is in the news due to the Thomas Duncan case.
Liberia has a population of 4,290,000 people, as of the latest figures there have been 3692 cases of Ebola, this represents 0.0086% of the population.Of those infections, 1998 people have died that’s a fatality rate of 54%. (source)
If that same infection and death rate were applied to the United States Ebola would infect 269,000 people and of those 156,281 would die.
Now, if as doctors and scientists fear the basic reproduction rate rises to 2 in Liberia the numbers change very quickly. Using the mean average incubation time of 9 days it would take around 13 weeks for the entire population of Liberia to become infected. (10 doublings starting with 3692 = just under the population of Liberia. This multiplied by 9 days gives us 90 days which divided by 7 gives 12.85 weeks.) Of the 4,290,000 people infected 2,316,000 would lose their lives.
This is just Liberia, not the other affected countries in West Africa.
Translated to an equivalent outbreak in the United States, where the basic reproduction rate is also 2, the numbers are horrifying. Starting with patient zero it would take around 245 days, 35 weeks for every person in the United States to become infected. Of those 17,118,000 people would die. (27.17 doublings x 9 days = 245 days =35 weeks)
Please remember the figures for Liberia are pulled from the CDC website, the percentages are correct.
United States was based on exactly the same parameters as for Liberia…a like for like comparison.
The CDC could be spending their time educating people, advising people to stock up, get ready for the possibility of staying in their homes. Self imposed isolation, or if need be state imposed isolation, that may last for an extended time period may become a reality. They’re not doing it though are they? They are sprouting figures and applying them to West Africa, and they can’t even get that right. They are saying that there could be 1.4 deaths in West Africa in a worst case scenario. When actually applying the figures they supplied with some simple mathematics we can see that 1.4 million deaths is a gross understatement.
Even a basic reproduction rate of 1.7, the latest figure for Liberia it will only take around 30 weeks to get to the same point as the above scenario, over 2,000,000 dead.
Don’t get me wrong, I am not saying that the UK government is any better, if anything they are worse, they don’t even try to do the maths. Most of them went to Eton (a very expensive school that churns out politicians) so it’s unlikely they would be capable of it even if they wanted to. You only have to look at our national finances to see they are no good at sums. They send out press briefings that there will be an emergency COBRA meeting, do you have any clue what that stands for? Let me enlighten you, Cabinet Office Briefing Room A. COBRA is not an emergency planning group, it’s an effing office.
Although I am loathed to say it, it’s time that our governments started worrying about the facilities at home rather than worrying about the facilities abroad. Stopping the disease in Africa does not mean we are out of the woods. There are so many unreported cases, people turned away from medica facilities in West Africa that nobody has the slightest idea how many cases of Ebola are actually out there. The porous borders of the region mean that people move around without the controls that are usually exercised in the west. There has to be a travel ban on non-US citizens entering the United States from these areas, the same applies from the UK.
Border control has to be improved in both countries if we have any hope of halting the spread of this terrible disease. The west is going to be the destination for anyone from Ebola hit areas that can afford to make their way from Africa. Many West Africans have contacts in the west who will help them get out, and shelter them when they arrive. As harsh as it seems this has to be stopped, it’s time for governments to put their own citizens first. Repatriation of your own is one thing, risking millions of lives at home because you won’t man up and prevent foreigners entering is quite another.
Guinea, Liberia and Sierra Leone have been struggling since March to stop what has become the largest Ebola outbreak ever recorded. The disease is causing widespread fear and disruption in West Africa, and shows no signs of being brought under control.
CHRONOLOGY OF COVERAGE
OCT. 15, 2014
Spain’s ad hoc, improvisational response to citizens infected by Ebola virus and brought back to the country underscores holes in West’s readiness to confront wider outbreak; cases of Ebola in Spain have raised urgent questions about risks of disease spreading even in developed countries, particularly among health care workers. MORE
OCT. 15, 2014
Doctors Without Borders criticizes lack of reliable evacuation systems from West Africa, saying that more would volunteer to fight Ebola in region if it were not so difficult to leave in case of emergency; cites fact that it took 50 hours to evacuate French nurse to Paris after she tested positive for virus. MORE
OCT. 15, 2014
Bellevue Hospital is designated as center for treatment of the Ebola virus should it emerge in New York City; announcement comes amid widespread concerns that disease may not be so easily contained by every hospital that has an isolation unit. MORE
OCT. 15, 2014
World Health Organization warns new cases of Ebola virus could reach 10,000 a week in West Africa by December, nearly 10 times the current rate; reports none of the three most heavily affected countries, Liberia, Sierra Leone and Guinea, are adequately prepared for epidemic; comments come in report before the United Nations Security Council, which voices fear that epidemic could renew the risk of political instability in a region barely recovering from civil war.MORE
OCT. 15, 2014
Dr Thomas R Frieden, Centers for Disease Control and Prevention director, acknowledges for first time that quicker and more concerted action on agency’s part might have kept Dallas nurse from contracting Ebola virus; says agency plans a more robust response to any future Ebola cases in American hospitals. MORE
OCT. 15, 2014
Frank Bruni Op-Ed column contends other, more common ailments deserve more concern and attention in United States than Ebola; points out influenza kills between 3,000 and 50,000 Americans per year, and skin cancer kills 10,000 per year; lists other common, and much-researched, illnesses that Americans should vaccinate and protect themselves against. MORE
OCT. 15, 2014
Jere Longman On Soccer column examines plight of SIerra Leone’s national soccer team, caught amid self-destructive feud between nation’s soccer federation and sports ministry; observes that team was already exhausted from playing road-only games due to Ebola outbreak. MORE
OCT. 14, 2014
Transmission of Ebola virus to Dallas nurse Nina Pham forces Centers for Disease Control and Prevention to reconsider its approach to containing the disease; state and federal officials are re-examining whether equipment and procedures are adequate or too loosely followed, and whether more decontamination steps are necessary when health workers leave isolation units. MORE
OCT. 14, 2014
Experience of Emory University Hospital in Atlanta in caring for three Ebola patients calls into question oft repeated assurances from federal health officials that most American hospitals can safely treat disease; transmission of virus to Dallas nurse Nina Pham has also raised questions about general level of preparedness in hospitals around the country; medical experts have begun to suggest it may be better to transfer patients to designated centers with expertise in treating Ebola. MORE
OCT. 14, 2014
Public health concerns about Ebola virus have spread to both political parties, which are engaged in finger-pointing debate that could jar midterm elections; Republicans blame the Obama administration for failing to protect the United States, and Democrats are saying it is GOP budget cutting that has put Americans at risk. MORE
OCT. 14, 2014
Experts rule out notion that Ebola virus has become a super-pathogen and raise doubts that it will evolve into one; say virus is not fundamentally different from those in previous outbreaks dating back to 1976, and it is highly unlikely that natural selection will give it ability to spread more easily, particularly by becoming airborne. MORE
OCT. 14, 2014
Friends of Dallas nurse Nina Pham describe the 26-year-old, part of the team that treated Thomas Eric Duncan, as conscientious and caring, and from a very private family. MORE
OCT. 14, 2014
Editorial warns effort to combat the Ebola virus in Western Africa is lagging dangerously behind; contends the international community must dramatically step up aid if epidemic is to be controlled; holds obligation is particularly strong for the United Sates as it faces first case of patient who contracted the virus domestically. MORE
OCT. 14, 2014
Sierra Leone’s national soccer team is enduring a series of demeaning and discouraging indignities since outbreak of Ebola in West Africa; team is barred from playing in its own stricken country and it must play every match on the road as it struggles to qualify for the 2015 Africa Cup of Nations, continent’s biennial championship. MORE
OCT. 14, 2014
World Bank president Dr Jim Yong Kim, frustrated with slow global response to Ebola outbreak, has made fighting epidemic his mission, driving bank to act on Ebola with uncharacteristic speed; bank has committed $400 million to fighting disease. MORE
OCT. 13, 2014
The topic everyone on Wall Street is discussing urgently but quietly isn’t the volatile stock market. It is Ebola. MORE
OCT. 13, 2014
News that a nurse at Texas Health Presbyterian Hospital has contracted Ebola virus transforms part of Dallas into scene of concern and contamination; residents in victim’s neighborhood are filled with anxiety, while hazardous-materials crews scramble to clean her apartment building. MORE
OCT. 13, 2014
Nurse at Texas Presbyterian Hospital in Dallas becomes first person to contract Ebola within United States; development prompts local, state and federal officials to scramble to determine how she became infected, despite wearing protective gear, and to monitor others potentially at risk; news further stokes fears among health care workers across country. MORE
OCT. 13, 2014
Centers for Disease Control and Prevention say agency will take new steps to help hospital workers protect themselves, providing more training and urging hospitals to practice dealing with potential Ebola patients. MORE
OCT. 13, 2014
Op-Ed article by Prof Siddhartha Mukherjee contends Ebola case of Thomas Eric Duncan in Dallas shows that medical community must rethink concept of quarantine, in light of the absence of any established anti-viral treatment; calls for development of pilot program for rapid-testing quarantine. MORE
OCT. 12, 2014
Liberian Army has suddenly become linchpin in fight against Ebola virus rampaging the country; for decades, Liberians viewed the armed forces with fear due to atrocities committed during civil war. MORE
OCT. 11, 2014
Doctors Without Borders, first to respond to Ebola crisis in West Africa, remains primary international medical aid group battling disease there; strained and overworked charity has erected six treatment centers in West Africa, with plans for more, and has treated the majority of patients, just as they have in previous Ebola outbreaks and some other epidemics in the developing world. MORE
OCT. 10, 2014
Health workers at International Medical Corps treatment center in Liberia face dilemma of how to care for newborn whose mother may have died of Ebola; many health workers have contracted Ebola while attending to births and being exposed to blood and other body fluids, provoking fears of providing maternity care; doctors speculate that Ebola can be transmitted from mother to baby (Series: The Ebola Ward). MORE
OCT. 10, 2014
Britain says it will introduce measures at airports and rail terminals to screen passengers from affected countries as concerns over Ebola grow in Europe. MORE
OCT. 10, 2014
Presidents of Guinea, Liberia and Sierra Leone, nations most affected by the Ebola outbreak, implore world leaders to increase their support to fight the disease; speak at meeting of the World Bank and the International Monetary Fund in Washington. MORE
OCT. 10, 2014
Nebraska Biocontainment Patient Care Unit in Omaha, with arrival of two Ebola patients in last six weeks, is at forefront of the nation’s response to the disease; unit’s 10 beds sat empty for years. MORE
OCT. 10, 2014
Dallas officials say Sgt Michael Monnig, local shefiff’s deputy examined for possible infection with Ebola virus, has tested negative and is sent home from hospital; many in city remain uneasy. MORE
OCT. 9, 2014
Thomas Eric Duncan dies of Ebola in Dallas, renewing questions about whether delay in receiving treatment could have played a role in his death and what role it played in the possibility of his spreading the disease to others; it remains unclear why, and how, Texas Health Presbyterian Hospital did not initially view the Liberian man as a potential Ebola case; nearly 50 people who came into contact with Duncan when he was experiencing active symptoms are being monitored. MORE
OCT. 9, 2014
Federal health officials will require temperature checks for the first time at five major American airports for people arriving from three West African countries hardest hit by Ebola epidemic; however, health experts say measures are more likely to calm worried public than to prevent people with Ebola from entering country; move comes after death of Thomas Eric Duncan, Liberian man who was the first person diagnosed with Ebola in the United States. MORE
OCT. 9, 2014
Bellevue Hospital Center in Manhattan shows off its isolation rooms and its leave-no-skin-cell-uncovered precautions in an attempt to reassure New Yorkers that should the Ebola virus arrive in the city, its premier public hospital could handle it. MORE
OCT. 9, 2014
European leaders are scrambling to upgrade their response to Ebola crisis after Pres Obama’s announcement that he will send 3,000 troops to West Africa to build hospitals and otherwise help in fight against the disease. MORE
OCT. 9, 2014
Spanish health officials explain how auxiliary nurse Maria Teresa Romero Ramos became the first Ebola case in Western Europe, saying that it was likely she became infected when she touched her face with the gloves she had worn while tending to a Spanish missionary with Ebola at a Madrid hospital. MORE
OCT. 9, 2014
Dog named Excalibur who belonged to Ebola-infected nurse Maria Teresa Romero Ramos is destroyed by Spanish health officials, even as protesters and animal rights activists surround Madrid home of the nurse and her husband; online petition calling for dog’s life to be spared drew hundreds of thousands of signatures. MORE
OCT. 9, 2014
Editorial notes new screening procedures directed at travelers entering United States from Guinea, Liberia or Sierra Leone, center of the Ebola epidemic in West Africa; holds screenings, while burdensome and possibly of little practical value, may ease public anxieties about keeping virus out of country and assure people that risks are being minimized. MORE
OCT. 8, 2014
Schedule for a single day at newly opened Ebola treatment center in Suakoko, Liberia, run by International Medical Corps charity, offers portrait of efforts to halt spread of virus; center is both ordinary and otherwordly, where health workers tend to those infected and those quarantined while awaiting test results (Series: The Ebola Ward).MORE
OCT. 8, 2014
Spain’s government comes under heavy criticism for its handling of Western Europe’s first Ebola case, as health care workers argue that they have not been given proper training or equipment to handle the disease; government quarantines three more people and monitors dozens who had come into contact with infected nurse. MORE
OCT. 8, 2014
Centers for Disease Control and Prevention scrambles to address concerns from health workers nationwide as anxiety mounts over Ebola virus; agency has scheduled two nationwide conference calls, but has so far not changed its recommendations on protective gear.MORE
OCT. 8, 2014
Doctors report first positive signs in recovery of Thomas Eric Duncan, Liberian man battling Ebola virus in Dallas hospital; Duncan’s temperature and blood pressure have normalized, though he remains on a ventilator and is still receiving kidney dialysis. MORE
OCT. 8, 2014
Centers for Disease Control and Prevention officials promise additional measures to screen airline passengers arriving in United States for Ebola virus; remain opposed to draconian travel restrictions such as outright bans, saying that they would cause more problems than they would solve. MORE
OCT. 7, 2014
Nurse in Spain becomes first health worker to be infected with Ebola virus outside West Africa, raising serious concerns about how prepared Western nations are to safely treat people with the deadly illness; nurse contracted the illness while treating a Spanish missionary who was infected in Sierra Leone and flown to Madrid, where he died; infection exposes weak spots in Spain’s highly praised health care defense systems. MORE
OCT. 7, 2014
Adel Faqih, Saudi Arabia’s acting health minister, says this year’s hajj has been free of Ebola and other contagious diseases like Middle East Respiratory Syndrome because of measures taken to protect more than two million Muslim pilgrims. MORE
OCT. 7, 2014
Pres Obama says screening for Ebola virus at airports both in the United States and West Africa will increase, but does not offer specifics; Dallas residents remain on edge as they await to learn if those who came into contact with Ebola patient Thomas Eric Duncan became infected. MORE
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‘Nothing is shut down, life & the economy go on’: Trump claims the oil price war behind markets crash is ‘GOOD for the consumer’ because gas prices are coming down and blames fake coronavirus news for historic drop
By KATELYN CARALLE, U.S. POLITICAL REPORTER FOR DAILYMAIL.COM and JENNIFER SMITH FOR DAILYMAIL.COM
PUBLISHED: | UPDATED:
Donald Trump claimed the oil price crash which led to the plunging stock market was ‘good’ for consumers because it is based on cheaper gas Monday as Wall Street faced a fall so dramatic trading was briefly halted.
‘Good for the consumer, gasoline prices coming down!’ Trump tweeted Monday, one of a string of tweets accusing the ‘fake news’ of prompting the sell-off.
He accused the media of ‘inflaming’ the virus outbreak and dismissed the collapse in oil prices as the result of Saudi Arabia and Russia ‘arguing.’
As the Dow Jones lost a year’s gains, he was shuttling across Florida from Mar-a-Lago to a $100,000-a-head fundraiser – and tweeting that flu was worse than coronavirus.
‘Saudi Arabia and Russia are arguing over the price and flow of oil,’ Trump continued in another tweet Monday morning. ‘That, and the Fake News, is the reason for the market drop!’
Markets all over the world plummeted Monday over the growing threat of the virus spreading, but Trump has not addressed the economic impact as the coronavirus death toll bypassed 20 in the U.S.
Global markets opened with big losses Monday morning as the economy saw its worst day in more than 10 years.
Trump continued to downplay the threat, citing that more people died from the flu last year, and insisting life and the economy will ‘go on’ even over the escalation in coronavirus outbreak.
‘So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year,’ Trump cited in a tweet.
‘Nothing is shut down, life & the economy go on,’ he insisted. ‘At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!’
The president has repeatedly expressed incredulity at the number of flu deaths, and the idea that people die of it. In 1918, his grandfather Freidrich died of Spanish flu.
Trump claims that media outlets are working with Democrats to make the coronavirus outbreak seem worse than it is.
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Donald Trump claimed Monday morning that the market drop is ‘good for the consumer’ because gasoline prices are coming down
The Dow Jones saw its worst single-day drop since 2008 as Saudi Arabia goes into a price war over oil and concerns over coronavirus spreading continues to rock, but Trump said the ‘fake news’ is the reason for the plummet
During his trip to attend a fundraiser in Orlando, Trump shook hands with supporters gathered to greet him
The president insisted while tweeting from Florida Monday that ‘life & the economy [will] go on’ as markets plunged and coronavirus concerns spread
Instead, he took to Twitter to laud himself and his administration for the response to the outbreak
Trump also praised himself for making the decision to halt travel from high-risk countries as the fast-spreading respiratory virus rose as a worldwide threat
‘The Fake News Media and their partner, the Democrat Party, is doing everything within its semi-considerable power (it used to be greater!) to inflame the CoronaVirus situation, far beyond what the facts would warrant,’ the president tweeted Monday morning.
‘Surgeon General, ‘The risk is low to the average American,” he continued, quoting U.S. Surgeon General Jerome Adams.
‘So much FAKE NEWS!’ he lamented in a separate tweet Monday morning.
Trump’s claims comes as the death toll in the U.S. reached 26 on Monday afternoon and cases continued to spread to new areas of the country, including the first confirmed case in Washington, D.C.
Kansas and Missouri also announced their first cases over the weekend as the cases number now exceeds 600.
The most U.S. deaths occurred in Washington state after the virus spread among residents at a nursing facility in a suburb of Seattle.
But Trump insists the threat is less serious than is being portrayed by media reports and Democratic lawmakers.
He then praised himself in another tweet Monday morning for banning travel from high-risk countries early on in the outbreak.
‘The BEST decision made was the toughest of them all – which saved many lives,’ Trump lauded of his administration. ‘Our VERY early decision to stop travel to and from certain parts of the world!’
Trump stopped travel from certain countries to the U.S., including from China and Iran – and Americans have been warned of traveling to other high-risk countries like Italy and South Korea.
The president is usually the first to address stock market gains under his administration, but since coronavirus has caused markets to fall, he has remained largely silent on the matter.
Earlier this month, the U.S. saw its worst week since the 2008 financial crisis and on Monday markets plunged nearly 7 per cent.
Markets in Asia, Europe and the Middle East also opened sharply lower on Monday as investors came to grips with the global spread of coronavirus.
Trump also praised Vice President Mike Pence, who he appointed last month to lead the charge by the coronavirus task force on addressing the outbreak and halting the spread
The global market plunged, causing the worst one-day crash in crude oil prices in 30 years, after Saudi Arabia launched a price war.
On Friday Russia refused to follow OPEC’s efforts to stop market plummets caused by the escalation of the coronavirus outbreak.
In early trading, BP was down by 18 percent, Royal Dutch Shell was down 14 percent and ExxonMovil was down 11 percent.
Ordinarily, a slump in oil prices offers a boost for airlines because their fuel costs are low.
But with the ever-shrinking demand for flights due to the virus, they have been left unable to capitalize.
The coronavirus crisis, which has now infected more than 110,000 people globally, has crippled supply chains and prompted cuts to global growth forecasts for 2020.
Downtrodden brokers on the floor of the New York Stock Exchange on Monday morning before the market opened
There are now more than 500 cases of the virus in the US alone
There is no sign that the spread is close to slowing down, either.
Traders are now expecting the Federal Reserve to again cut interest rates next week after an emergency reduction on March 3, putting the yield on benchmark 10-year U.S. Treasury on course for its biggest one-day fall in almost a decade.
Shares of rate-sensitive U.S. banks Citigroup Inc, Bank of America Corp, JPMorgan Chase & Co, Goldman Sachs, Wells Fargo & Co and Morgan Stanley slid between 7.4 percent and 9.6 percent.
Marathon Oil Corp, Devon Energy Corp, Apache Corp, Pioneer Natural Resources Co slipped between 22 percent and 28 percent and were some of the biggest losers among S&P 500 components.
At 7:12 a.m. ET, Dow e-minis were down 1,255 points, or 4.87 per cent. S&P 500 e-minis were down 145 points, or 4.89 percent and Nasdaq 100 e-minis were down 410 points, or 4.82 percent.
Much of the chaos has been sparked by the failure of a deal between OPEC Saudi Arabia and non-OPEC leader Russia.
Generally, the world’s largest oil producers agree on production rates and cuts in order to stabilize the industry.
With coronavirus slowing demand for supply, they met last week with Russia, which is not part of OPEC but is a large oil producer, to discuss cutting production.
Russia refused, setting in motion a chain of events described by analysts as a ‘worst case scenario’ that could descend into an all-out price war.
Last month, Trump appointed Vice President Mike Pence to head the task force addressing the coronavirus crisis.
‘Great job being done by the @VP and the CoronaVirus Task Force. Thank you!’ Trump tweeted Monday.
Coronavirus has infected more than 108,000 people worldwide and is throwing many countries’ economies into turmoil.
The number of confirmed cases in New York rose by 13 over the weekend, nearing the state total to 90.
New York governor Andrew Cuomo issued a declaration of emergency in the state.
But Trump claimed late Sunday night that the messaging from Cuomo is ‘political weaponization’ of the coronavirus.
‘There are no mixed messages, only political weaponization by people like you and your brother, Fredo!’ Trump insisted in his tweet, making reference to Cuomo’s brother, CNN anchor Chris Cuomo.
HOW SAUDI ARABIA IS TRYING TO CRIPPLE RUSSIAN OIL
Saudi Arabia slashed its oil export prices over the weekend and declared a price war with Russia that sent global markets reeling and marked the sharpest decline in oil futures since 1991.
The price drop came after Russia refused to sign on with a proposal by the Organization of the Petroleum Exporting Countries (OPEC) to cut production globally as the coronavirus outbreak has slowed the demand for oil.
OPEC nations met with allies like Russia on Thursday and Friday in Vienna to reduce oil production by an additional 1.5million barrels per day to stabilize the market starting in April through the end of the year.
But Russia refused to join to agreement.
From Russia’s perspective cutting production would boost US oil producers at the expense of international competitors and lead to a loss in profits.
On Saturday, after the group failed to come to a consensus, Saudi Arabia – which runs the world’s large oil company Saudi Aramco – slashed its export oil prices to saturate the market and trigger a price war aimed at Russia.
An oil price war triggered by a falling out between Saudi Arabia and Russia is exasperating the economic chaos. Crown Prince Mohammed bin Salman (left) and Russian president Vladimir Putin (right)
Saudi Arabia slashed crude prices to Chinese customers by as much as $6 to $7 a barrel and is looking to boost output by as many as 2million barrels a day.
China is the world’s biggest oil importer and has purchased oil at cheap prices to stockpile for future use in the past.
As a result the Brent global oil benchmark fell dramatically on Sunday by 30 percent, dropping to $31.02 a barrel at its lowest.
US West Texas Intermediate crude, the other main price benchmark for oil, dropped 27% to $30 per barrel – the lowest level since February 2016.
Sunday’s decline in the oil market was the sharpest slump in 29 years since the Gulf War in 1991.
Global stock markets took hits on Sunday with the Tokyo stock market index plunging 6.2 percent, Hong Kong 3.9 percent, Sydney 6.1 percent, and Riyadh eight percent.
The failed talks marked the first break in a three-year alliance between Saudi Arabia led by Crown Prince Mohammed bin Salman and Russia’s President Vladimir Putin.
The alliance was key to competing with a surge in American oil production that turned the US into a major crude exporter for the first time in decades.
In response to the price cut Russia said its companies were free to pump as much as they could, as per Bloomberg.
‘If you are Russia, it’s worth it for you to take a three-month price hit to see if you can knock out U.S. oil exports,’ Amy Myers Jaffe, an oil and Middle East expert at the Council on Foreign Relations, said to the New York Times. ‘They might be correct for three months but the shale never gets destroyed.’
Jaffe said the disagreement between the two nations ‘signals that the relationship between Saudi Arabia and Russia is on the skids.’
Analysts speculate the actions over the weekend may have been a game between Saudi Arabia and Russia that will end when they come to a compromise.
If not, oil prices could tumble to the lowest level in five years
https://www.dailymail.co.uk/news/article-8091389/Trump-ignores-market-plunge-death-toll-accuse-media-Dems-inflaming-coronavirus-crisis.html
Story 4: Airlines Blame Big Lie Media Mob For Pushing Pandemic Panic — Videos
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Travel slump worsens as airlines try to blame media
Health officials have warned, though, that it may not be safe for everyone to fly everywhere.
International departure terminals are quiet Saturday at John F. Kennedy Airport as concern over the coronavirus grows. | Spencer Platt/Getty Images
By SAM MINTZ
Updated:
In a statement Tuesday morning, the trade group Airlines for America said that “false media narratives … have led to confusion and uncertainty across the country,” and argued that it’s safe to fly, saying “numerous health officials have affirmed that the risk remains low for travelers who follow CDC guidelines.”
Sen. Maria Cantwell, the top Democrat on the committee that oversees aviation, said she didn’t fly home to Washington state last weekend and doesn’t plan to in the foreseeable future.
“I have an 88-year-old mom who’s living at my house [in Washington] and she’s been ill, and I want to give her the comfort of being there. When you have elderly people you want to make sure you’re not putting them at additional risk,” she said. “And look, do I think that there can be airline travel that is safe? Yes. But if you don’t have to…”
Sen. Richard Shelby (R-Ala.), 85, noted that the doctor said “stay off of those planes as much as we can.”
“If any of you is going to Alabama Thursday night, can I get a ride?” Shelby quipped to reporters gathered around him Tuesday. “I’ll ride in the back of the truck.”
Also Tuesday, a coalition of mostly travel interests spearheaded by the U.S. Travel Association made a similar plea, noting that canceling travel and events “has a trickle-down effect that threatens to harm the U.S. economy, from locally owned hotels, restaurants, travel advisors and tour operators to the service and frontline employees who make up the backbone of the travel industry and the American economy.”
Yesterday, the credit rating agency Moody’s downgraded the industry’s outlook from stable to negative, warning that there is an “increasing risk to demand for passenger air travel as the coronavirus expands globally.”
And today, the Global Business Travel Association reported that business travel is “slowing at an alarming rate,” finding that 13 percent of its members have canceled even domestic travel, along with high rates of canceled international business travel.
“Those are the customers that are the most profitable for airlines,” said airline analyst Henry Harteveldt.
Though airlines have yet to publicly ask for assistance from the government, the potential for some kind of stimulus has been a topic of discussion on and off Capitol Hill for days, and President Donald Trump has indicated that he favors some assistance for airlines and the cruise industry.
On Tuesday, Trump, along with Treasury Secretary Steven Mnuchin and National Economic Council Director Larry Kudlow, met with Senate Republicans at their weekly lunch to discuss potential stimulus ideas on a range of topics.
Several Republican senators said that support for the airline and cruise industries was discussed generally, but that few specifics were given.
Sen. Roger Wicker (R-Miss.) chairman of the Senate Commerce Committee, said that he had not been approached by either industry asking for aid.
Despite the fresh bad news, there is still a high level of uncertainty in the outlook for airlines and the travel industry broadly. “At this point, you cant really do forecasting because we’ve never really been in a situation quite like this before,” said Harteveldt.
And it remains true that overall, the industry is in much better shape than it was after 9/11 and in 2008, when airlines were hit hard by the recession, said Bob Mann, another airline industry analyst.
“The industry structure and company’s balance sheets individually are in far better shape,” he said. “Even the worst balance sheets are better than the average balance sheets in 2008 and 2001.”
Airlines have been taking steps to reduce their capacity, which Mann called “prudent.”
American Airlines is the latest to make that call, announcing this morning it would cut summer international flights by 10 percent and domestic flights by 7.5 percent. Delta Air Lines also said Tuesday that it is cutting international flights by 20 percent to 25 percent and domestic flights by 10 percent to 15 percent.
https://www.politico.com/news/2020/03/10/airlines-travel-slump-coronavirus-125016
Story 5: President Trump Awards Presidential Medal of Freedom to General Jack Keane —
Trump awards Gen. Jack Keane with Presidential Medal of Freedom
Jack Keane
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John M. “Jack” Keane (born February 1, 1943) is a retired American four-star general, former Vice Chief of Staff of the United States Army and Presidential Medal of Freedom recipient. He is a noted national security analyst, primarily on Fox News, and serves as chairman of the Institute for the Study of War and as chairman of AM General.
Contents
Personal life
Keane was born in 1943 in Manhattan, New York,[1][2] the son of Elizabeth (Davis) and John Keane. He has a brother, Ronald. Keane married Theresa Doyle in 1965 and has two sons.[3] His wife died in 2016 after having Parkinson’s disease for 14 years.[4]
Education
Keane attended Fordham University, where he participated in The National Society of Pershing Rifles, graduating with a bachelor’s degree in accounting in 1966. He then attended Western Kentucky University, graduating with a master’s degree in philosophy. He later attended the Command and General Staff College and the Army War College.[3]
Career
Military service
Keane (left) meeting with an army colonel
Keane served in the Vietnam War as a paratrooper.[5] He later served in U.S. engagements in Somalia, Haiti, Bosnia and Kosovo. His commands include the 1st Brigade, 10th Mountain Division, 101st Airborne Division and the XVIII Airborne Corps.[3]
In 1991 Keane saved the life of David Petraeus during a live-fire exercise. According to Keane, Petraeus was shot “accidentally, standing right next to me, and I had to fight to save his life. He had a hole about the size of a quarter in his back and is gushing with blood, and we stopped the bleeding and got him on a helicopter and got him to a surgeon and so we were sort of bonded ever since that time.”[6]
Keane retired from military service in 2003.
Post military service
Following his retirement, he has served as an informal advisor to presidents and other senior officials. He served an advisory role in the management of the U.S. occupation of Iraq, as a member of the Defense Policy Board Advisory Committee. In January 2007, Keane and scholar Frederick W. Kagan released a policy paper titled “Choosing Victory: A Plan for Success in Iraq,”[7] through the American Enterprise Institute that called for bringing security by putting 30,000 additional American troops there for a period of at least 18 months. In part convinced by this paper, President George W. Bush ordered on January 10, 2007, the deployment of 21,500 additional troops to Iraq, most of whom would be deployed to Baghdad. This deployment has been nicknamed the 2007 “surge“.[8][9]
Of his initial meeting with President Bush regarding the surge, Keane said he made a phone call to Newt Gingrich to ask his advice prior to the meeting. As Keane said in 2014,
Keane was asked by then-Vice President Cheney to go back on active duty and lead the surge in the field. When Keane declined, Cheney pressed him to come work in the White House and oversee both the wars in Afghanistan and Iraq; Keane again declined. Keane ended up briefly working at the White House and then later traveled to Iraq several times to advise General Petraeus.[11]
Current activities
Keane is a regular contributor to Fox News, and is involved in a variety of business, think tank and charitable activities. He serves as chairman of AM General, the firm that produces the Humvee.[12][13]. In June 2016, Keane co-founded IP3 International (IP3), a nuclear energy consulting firm.
Keane is an advisor to the Spirit of America, a 501(c)(3) organization that supports the safety and success of Americans serving abroad and the local people and partners they seek to help.[14] He formerly served as a strategic advisor for Academi and is a former director of defense giant General Dynamics.
Shortly after Stanley A. McChrystal declined the Secretary of Defense job, Vice-President Elect Pence heard the emotional reasons for the newly widowed general’s decline of the same job. After the departure of General Mattis, the President offered the job again to the subject, but he declined because he was newly remarried.[15] He is considered an influential voice to leaders from both major political parties, including President Trump, particularly on foreign policy issues related to the Middle East.[16]
IP3
Keane is a cofounder and director of IP3 International.[17] According to a staff report to the chairman of the House Oversight Committee, during the 2016 U.S. presidential campaign of Donald Trump, and subsequently, Trump aides such as Jared Kushner and others have been engaged in promoting IP3’s plan to transfer nuclear technology from the U.S. to Saudi Arabia. According to the report, IP3 founders and others have been seeking to broker a deal with Riyadh without the “gold standard,” a provision — tied to section 123 of the 1954 Atomic Energy Act which establishes conditions for nuclear cooperation between the U.S. and its allies — that seeks to limit weaponizing of nuclear energy.[18][19] In July 2019, the committee chairman released a second staff report that detailed various activities and contacts between IP3 and the Trump administration.[18] [20]
Awards and decorations
Military awards Keane has received include two Defense Distinguished Service Medals, two Army Distinguished Service Medals, the Silver Star, five Legion of Merits, the Bronze Star Medal, three Meritorious Service Medals, one Army Commendation Medal, the Joint Chiefs Service Badge, the Humanitarian Service Medal,[3] Ranger Tab, Combat Infantryman Badge, Master Parachutist Badge, and Air Assault Badge. President Donald Trump has announced that Keane is set to receive the Presidential Medal of Freedom on the second week of March 2020.[21]
His civilian awards include the Fordham University Distinguished Alumni Award, the USO 2002 Man of the Year award, and the Association of the United States Army 2001 Man of the Year award.
References
External links
Eric Shinseki
1999–2003
George Casey
https://en.wikipedia.org/wiki/Jack_Keane
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