A second caregiver following all established protocols is now infected and the CDC can't explain it. That's comforting. And they are managing expectations and doing preemptive damage control by warning people there could be more.

Here's what I don't get - You are dealing with one of the most deadly diseases on the planet and people are willing to believe that it will remain stable and predictable in it's behavior.

How do you know it won't mutate and that the delivery mechanism changes? How can you be sure that someone doesn't become an asymptomatic carrier? Typhoid Mary didn't have any symptoms. Many Herpes carriers have no symptoms.

This disease is serious. Very serious. That someone, anyone, particularly a TV doctor, could be so cavalier about something so potentially dangerous is beyond me.

In my opinion, this is a clear case where an abundance of caution is truly warranted.

Misinformed vs informed: opinion linked with hysteria vs science. Simple as that. I will listen to the CDC any day before making decisions based in hysteria. To do otherwise is ...well...irrational.
Dr. Nancy used sound science based judgement in going out in public, but totally misjudged the hysterical media hyped reaction *misinformed* people would have. Off with her head!!!

We have 2 confirmed cases in the USA & people spurred by the media are hysterical!

Bee, I suggest you actually do some reading on this virus. The science is quite clear.

I'm certain you are also aware that the virus can be carried by animals which don't exhibit symptoms.

Here is a link that might be useful: Facts

This post was edited by tally on Wed, Oct 15, 14 at 10:38

We have a physician in the family and when I asked him what he thought he said she should be fired by the network and professionally censured by the state licensing board.

He believes once she voluntarily agreed then it was her moral obligation both individually and as a physician to honor the quarantine. Additionally he felt as a NBC physician she bears the additional obligation to lead by example.

I doubt the network will do anything.

There are two separate issues here, the possibility of infection, and the possibility that others will copy Dr. Snyderman and break quarantine.
I think that as a role model, she should not have broken the quarantine even if at the time it was voluntary.

I had mixed thoughts but as the concern grows I think she should be fired from NBC. Quarantined means stay at home inside the house. I remember years ago our family was quarantined with chicken pocks. We all stayed inside for many days as I remember.
Mary

I just read the facts that Tally posted--I was wrong about animal transmission. But from bats to humans is one thing. From what I read the nurse would have had to eaten her dog to get infected.

dogs and ebola

Here is a link that might be useful: read this

Tally, yes. She's written some somewhat 'frothy' books on subjects that sell, she does know how to make money. But this isn't a stupid woman and she should have known better, known she would be held as an example as person in the public eye. She's a licensed pediatrician and was a practicing otolaryngological surgeon of somewhat high regard.

On-air TV presenters are chosen for their looks, not for their brains. For female weather people, since they're seen from head to toe, being thin and looking good in tight clothes also matters for a job interview. But like the anchors, they're reading the results of someone else's work, they don't do the technical work themselves. Credibility isn't a factor in their success.

"Expert" correspondents, whether legal, medical, military, etc., develop their own material and comments. They're expected to use their special knowledge to digest events and translate them into words their viewers can understand. Credibility and reputations matter.

As I see it, this person's main claim to fame is that she is a female physician and is a 60-something who looks like a 50-something. She has shown herself to have bad judgement and a touch of arrogance, to me that's enough to throw her credibility into question. She's easy enough to replace.

I agree that her credibility has been totally compromised.

IMO people are most frightened by the death rate cited for Ebola.

Yet, the only rate I know of is the rate in West Africa, where people dismiss and distrust modern medicine. Even if they did trust it, they have abysmal access to medical help. The death rate was 90% *in West Africa*. With the addition of more medical attention, it's quickly dropped to 70%.

What's the news from First World areas where Ebola patients have been identified and are being treated? I've heard of two in the US who have recovered. Platelets from one are being used to treat the infected nurse in Dallas.

Health providers worldwide have to step up their learning curve about tropical diseases if they are to diagnose, isolate, and treat Ebola -- and protect themselves.

I don't know when the Dallas nurse contracted Ebola. The now-deceased Ebola patient was in the hospital twice before he was isolated and protective gear was mandated.

I do wonder about all the other people who came into contact with the man before his isolation. We know the occupants of his Dallas apartment are in isolation. Do we know what outreach there has been to others with whom he came into contact in the first ER visit and later? On the street? By what date would these individuals be considered 'safe'?

Viruses do mutate. Some become more virulent. Some become less virulent. Some just seem to fade away or are nearly eradicated by medical advances.

She was asked to submit to a voluntary quarantine. She agreed. She then willfully and arrogantly violated that agreement. Even in her supposed apology she doesn't own up to it:

During the NBC Nightly News broadcast on Monday, anchor Brian Williams read out the following statement from Snyderman:

"While under voluntary quarantine guidelines, which called for our team to avoid public contact for 21 days, members of our group violated those guidelines and understand that our quarantine is now mandatory until 21 days have passed. We remain healthy and our temperatures are normal.

She only says "members of our group violated those guidelines" not I violated those guidelines. She might as well have said "Although I agreed to their silly voluntary quarantine to assuage their fears, I'm so important that I shouldn't have to be true to my word. After all I'm a TV doctor I know more about it than they do."

I see there is now a second medical provider linked to Mr. Duncan's case who has Ebola. BOTH women (Ms. Phan and Ms. Vinson) treated Duncan at the hospital in Dallas when his Ebola was full blown, but *before* he was diagnosed and *before* they were ordered to don protective gear.

Now the second woman, Ms. Vinson, has flown to Cleveland (without symptoms) and returned to Dallas (with symptoms, but we don't know how severe).

I have not heard of any other new Ebola cases other than these two, both linked to Duncan, have you? I suspect there will be some, and some linked to Duncan through Phan and/or Vinson.

Do we think the servicemen now aiding with building hospitals and training others in West Africa will be isolated for a month before coming home?

Chisue, lots of things being broadcast and some of it aired prematurely regarding Ebola developments. The news article that was on in my office this morning (DH has a way of turning on the television in here even though he's on his way out for the day) said....

They suspect the broken protocol with the protective garments can be traced to the way they were removed, not the way they were worn. That conflicts with you hearing the healthcare workers were not wearing protective gear.

It might be best if all of us and I include myself in that, just sit quietly back and see how things develop. This circumstance and the information is so new to all of us, hopefully everyone will be better informed when some experience has been obtained with treating those who are becoming ill - making prevention more complete.

I'm trying to keep pouring only facts on the troubled waters. LOL (However, it was a TV 'crawl' that stated the two women treated Duncan before he was diagnosed, and I may have *presumed* they were not wearing protective gear.)

Bee, I agree that was a strange attack on you.

But regarding the claim that Nancy Snyderman had no symptoms and posed no risk to the public, then why quarantine her at all? I'll tell you why. Someone doesn't have symptoms until they do have symptoms, and presumably that can happen at any moment during the quarantine period.

I cannot imagine she will go back to work at NBC. I liked her as a reporter, but she no longer has credibility.

Stupid is as stupid does. This was really stupid.

She never got out of the car!

Can someone please explain to me how she put anyone in danger?

It was a voluntary quarantine and as long as she didn't go into the restaurant and rub all up on all the patrons, she didn't do anything to be fired for. She posted no threat to anyone.

The scary thing is, healthcare workers are exposed to everything under the sun before their patients are diagnosed, TB, c-diff, among them. I've had patients with TB and the flu cough in my face before they're diagnosed.

We're also exposed outside of the hospitals, all of us, to VRE, MRSA, C-diff, etc...Wash your hands after you touch that shopping cart and before you eat anything or rub your face or eyes. We also can't make family members use protective gowns and gloves and most don't. They come out of the rooms and touch the nurses' station, door handles, elevator buttons.

"It was a voluntary quarantine and as long as she didn't go into the restaurant and rub all up on all the patrons, she didn't do anything to be fired for. She posted no threat to anyone."

Did I miss something? Were the guidelines of the voluntary quarantine "you can go wherever you want, with whomever you want, whenever you want so long as, in your esteemed opinion, you don't put anyone else at risk"?

Yes, apparently you did miss something Lindsey,

"Frieden said Vinson shouldn't have flown because she helped care for Ebola patient Thomas Eric Duncan at Texas Health Presbyterian Dallas, and because another health worker who cared for Duncan had already been diagnosed with the virus.

"The CDC guidance in this setting outlines the need for what is called controlled movement. That can include a charter plane, a car, but it does not include public transport," Frieden said. "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."

Again, she didn't put ANYONE at risk by sitting in her car.

Here is a link that might be useful: CNN

Apparently you don't understand satire, Magic. Snyderman's quarantine has NOTHING to do with nurse Vinson.

Snyderman agreed to a quarantine and she broke her word.

I'm sorry I truncated her quoted statement, but that still doesn't cut it as an apology. In my opinion any "apology" containing a "but" clause, is inherently not a true sincere apology.

Apparently all she is sorry for is is that we were "concerned" and then pulls back even that weak apology with her statement of "As a health professional I know that we ... pose no risk to the public"

She doesn't even seem to believe she has done any thing wrong -- To her, its just us with our silly unfounded concerns.

She was asked to submit to a voluntary quarantine. She agreed. She then willfully and arrogantly violated that agreement. As a health professional she should certainly know what a quarantine means and why they are an important part of infection control.

Vinson was being monitored for exposure. She was
not under quarantine. Apples and oranges.
Agreeing to voluntary quarantine means you will isolate
yourself. Snyderman did not isolate herself.
Now she's under mandatory quarantine....enforced
isolation.

She was under voluntary quarantine. For a doctor to break that is inexcusable. Quarantine doesn't mean that you get to go out as long as you stay in the car or keep a certain distance from people. As a doctor and someone who is on national tv, she set a terrible example.

I know this is a stretch, but what if that car that had been in an accident with injuries and there was blood involved? Or if she had suddenly gotten ill, while riding around? Seems like an unnecessary risk to take for soup.

I can understand drawing Ms.Vinson into the discussion & drawing parallels. She was in direct contact, caring for a later diagnosed EVD pt., yet was not put under mandatory isolation. Dr Nancy didn't take care of such a pt. The info Majic posted makes me think that, at most, maybe dr Nancy should have been under "controlled movement"?

Just what are the guidelines of voluntary isolation, if any? I wonder who suggested "voluntary" isolation? Maybe NBC? The fact that it was voluntary makes me think it was not based on health policies. I wonder too if NJ Health Dept is now isolating everyone who comes from West Africa? The policies need to uniformly enforced & in line with CDC guidelines. We don't need to expend monies & energies needlessly, let alone add to the publics' confusion, prompting outrage over a technicality.

I have been through nursing school and worked in hospitals so I have some knowledge about quarantine. After a moment of thought on this I also feel she shouldn't have gone anywhere, even in the back of a car.

Say she is on the threshold of being ill, and she coughs on her lower arm or hand, while walking down the hall to get in the car. She opens the building door to leave, she opens the car door and enters. Sitting on leather seats, she coughs again and gets out her credit card and hands it to the front passenger while her arm rubs against the head rest. Later the wife of the driver decides to get the car as the camera man won't need it for two more weeks. She puts her toddler in the back seat where Snyderman was, but the child grabs the headrest where the tiny amount of ebola was left. He then sits in his car seat and gnaws on his hand for a minute. Can anyone see how many ways this scene could go? Chances are good everyone will be fine, but should she have taken that chance?

I don't see any reason for her to take any chances. Ever. This is something she can do for a short period of time. And it's serious enough for her to do. If we don't know enough about this disease (when and how you can transmit it does seem to be evolving), why subject anyone to a chance happenstance? Just stay home already. She could afford not to work at all and order in food. Plenty of time she could finish that scrapbook she's been meaning to make, catch up on her magazines, and write a book. Wouldn't have hurt anything. Go stand in your own backyard and breathe that air, and be outside there.

How much nicer if Dr. Nancy had done a 'remote' for TV -- from her home isolation! She could have asked if someone would please bring some of that wonderful soup and leave it on her doorstep.

On another front, since people keep quoting high mortality rate of Ebola by citing the rate in West Africa, might we hear the death rates there due to cholera, typhoid, TB, flu, various poxes, polio, etc.? How many of the Ebola deaths there were only identified post- mortem? How many people were diagnosed and treated in early stages of the disease?

This is not The Black Death. This isn't the 14th Century. People don't show symptoms of Ebola and die in 24 hours. This isn't West Africa.

Can someone get ebola from leaving some soup on her doorstep?

Adding to this:

On another front, since people keep quoting high mortality rate of Ebola by citing the rate in West Africa, might we hear the death rates there due to cholera, typhoid, TB, flu, various poxes, polio, etc.? How many of the Ebola deaths there were only identified post- mortem? How many people were diagnosed and treated in early stages of the disease?

How many people there have contracted the virus, had a relatively mild response -- a fever, some aches, minor nausea, whatever -- and fought off the disease without ever knowing that they had ebola?

How many people there have contacted the virus, but were entirely unaffected by it?

You can't be serious, Rob. I'll just take your comment as a joke, or sarcasm. Whatever.

At this moment, I don't give as much credit to the treatment as I do to the health of the caretakers. American caregivers are generally healthier than the villagers in Africa. Even the missionaries have health advantages, having come from much healthier areas. Vaccinations, better foods, less mental and physical stresses. Many things going into beating the odds of Ebola once it has been contracted.
I'm more concerned that we won't have the facilities to help everyone and a code of conduct needs to be implemented now for families to know what to do if they should come down with this deadly disease. If you are deathly ill, throwing up constantly, running a high fever, bleeding. What should a family do. As much as I would want to run my family member over to the nearest hospital, I would not. Would others think like me. I know they won't. So many only see the present, not thinking about how this could affect so many. I would hope and pray I could get an IV set up at home. That the doctors would keep me informed of the latest and most helpful antidotes. That they would allow me to medicate my loved one as needed.
WE need to address the question of what Americans need to do in case there would be an outbreak, BEFORE it happens. Hysteria happens when people are uninformed and from what I've seen, there are plenty of those. Even with information, this could potentially be a huge shock to the USA. We may have better healthcare but our transportation is also amazing with people traveling everywhere in a matter of hours. In the past, areas most subject to Ebola probably didn't have as many people traveling in and out.
There are soooo many variables, I can't even begin here. We don't have a cure, no one does. So I am patiently waiting for the big dogs to come up with some guidelines for our country, to prepare healthcare workers as to what they can and cannot do outside of the hospital and in what time frame they can do it. A sick person at home doesn't have three weeks to get the ok for an IV or other meds, especially when a doctor hasn't seen them. Really, do you want to be in the medical center waiting room as the next patient to be seen, while the ebola patient leaves the room with a barf bag, that is if he has any energy left at all? When was the last time you called your doctor/nurse and told them you know what you have and please send some meds? That doesn't happen unless you have an ongoing problem. So that needs to be addressed, along with hydration and the protocol for others living in the same house. Can they go to work and return home everyday? This has the potential to be so much worse than Aids. It's not comparable..

total sarcasm.

Toni -- I think you are 'way ahead of probability, at least on Ebola, but I agree that having *A Plan* is always good.

I would start with telling media to quit the headless-chicken-in-the-barnyard routine and to start providing simple FACTS about the current international state of Ebola virus -- with maps.

AFAIK we've had ONE death from Ebola in America, Mr. Duncan, who was first misdiagnosed, then presented too far gone to save. I see TWO persons diagnosed with Ebola, both diagnosed quite early and being treated -- neither having contracted the disease while adequately protected.

Are there more Ebola patients in the US? In the rest of the Western World?

I think this bit might provide some reassurance that the USA can handle more than a few Ebola cases. We already have systems & trained personnel maybe not specifically for EVD, but isolation principles are the same.

****""Firestone Tire and Rubber Company has successfully contained the spread of Ebola among 80,000 people living in Harbel, the Liberian town housing employees of FirestoneâÂÂs Liberian plant and their families. In March, after the wife of a Firestone employee developed Ebola symptoms, Firestone constructed its own treatment center and implemented a program of quarantine and treatment. Firestone has successfully kept the Ebola virus from spreading among its employees."***

Another pertinent fact is that when a person very first gets ill with Ebola, commonly a fever>100.5F, they are shedding very little, if any virus. The risk greatly increases with *direct* contact with bodily fluids (not a goober early on,in the back seat of a car) as the disease progresses. As the virus replicates, cells lyse the person becomes gravely ill & begins losing control of bodily fluids as in vomiting & diarrhea that have high viral load in the later stages of the disease. That is when risk is highest for contracting the disease.

I'm just trying to calm some fears generated by "what ifs" that are not grounded in science.

Thanks, BEE! That's the sort of information the media should be making available.

Also, as I understand it, by the time an Ebola patient is very infectious, he is too weak to move, much less *travel*.

The original guy got on an airplane.
One nurse got on an airplane and then got on another airplane.
One nurse got on a cruise ship.

Apparently the first symptom of ebola is taking a trip somewhere.

Eclair, very funny! ;-)

Eclair, LOL

Eclair, now THAT is funny!! Thanks for lightening things up a little bit.

ÃÂclair that was priceless. And maybe even funnier to me since I have no travel plans in the near future....

I haven't followed this story, but if the quarantine was "voluntary," as suggested above, then she did nothing wrong.

"I'm just trying to calm some fears generated by "what ifs" that are not grounded in science. " Bee, I wish the media would do that!

Millions of Americans have been diagnosed with OCD and other anxiety disorders. These personalities operate on a 'what if' rationale of fearful alert. These are disorders of the mind. Afflicted people can't help their feelings, other than remembering that they are prone to false perceptions.

The rest of us can more easily be guided by facts. NONE of the people who came into contact any of the THREE documented cases of Ebola in the US have developed the disease. Incubation is normally three to eight days; Duncan's contacts have stayed isolated for 21 days 'just in case', and have NOT developed Ebola. Even Mr. Duncan might not have died if the ER had recognized his Ebola when he first came to the hospital, before the disease was obvious.

I predict we won't see Dr. Nancy until this all blows over. Maybe she's ready to retire. Most females on TV have a 'sell by' date.

"The rest of us can more easily be guided by facts. NONE of the people who came into contact any of the THREE documented cases of Ebola in the US have developed the disease."

This is a gross misstatement of the facts. The second and third documented cases of Ebola in the US contracted the disease from the first documented case.

Lindsey -- Have I been unclear? I meant to make the point that Ebola has not been diagnosed in anyone beyond the three documented cases: Duncan and his two nurses. The maximum gestation period has now passed for those who were in contact with these three, and NONE of the contacts has developed Ebola.

To me, this shows that the spread of Ebola *in the Western World* is very unlikely.

But those who were truly at risk are no longer quarantined. It's over!

Here is a link that might be useful: quarantine over

Did ... Nancy ... get ... fired?

o j

We...don't...know. But there have been no 'sightings', at least none by me.