Dallas Official: Ebola Hospital Never Warned About Travel

[KamaAina]

http://www.nbcnews.com/storyline/ebola-virus-outbreak/dallas-official-ebola-hospital-never-warned-about-travel-n226796

Dallas County Judge Clay Jenkins criticized the CDC hours after it was revealed that a second nurse who came into contact with Ebola patient Thomas Eric Duncan at Texas Health Presbyterian Hospital has tested positive for the deadly disease, and that the new patient flew on a commercial flight to Ohio before she was diagnosed.

Jenkins, the chief executive in Dallas County, said he is seeking an order to bar 75 hospital workers who may have come into contact with Duncan, who died of the disease last Wednesday, from taking mass transit. Early Wednesday nurse Amber Joy Vinson tested positive for Ebola, becoming the second nurse who treated Duncan to be diagnosed with the disease that has killed more than 4,000 people in the West African countries of Liberia, Sierra Leone and Guinea.

“I’m not happy about the lack of direction on travel restrictions. If restrictions aren’t put in place immediately we’ll put them in place on a local level,” Jenkins told NBC News. “We can’t have people out on public conveyances, on airplanes.” Jenkins was careful to say that the government doesn’t believe the order will need to be enforced, calling those who treated Duncan “heroic health care professionals” who just need some guidance on travel.

CDC Director Dr. Thomas Frieden said Wednesday that Vinson should not have boarded a commercial jet after she was exposed to Ebola and developed a mild fever, but those instructions were apparently never communicated to the hospital staff who came into contact with Duncan. The other nurse, Nina Pham, 26, tested positive for Ebola on Sunday. She is being treated at Texas Health Presbyterian and was in good condition Wednesday, the hospital said.

[randys1]

1. Great idea, lets make sure all ebola patients are forced to say in areas where healthcare

is lacking so they can spread the disease even more

fucking morons

[jwirr]

6. There is a difference between hopping into a plane to visit someone across the country and being

taken to a special hospital such as Emory in an emergency vehicle.

[Peacetrain]

2. I am having some issues with people saying they have not been warned about travel

That is all we have been talking about for the last couple of weeks..low grade temps.. flights into the United States..

[MattP]

4. its common sense your self monitoring don't fly!

[notadmblnd]

11. yeah, me too.

[uponit7771]

32. unnnn, not everyone is tethered to the same news channels

[jwirr]

3. Do these administrators want to have some else do all their thinking. It came to them via travel

in the first place and they do not understand that keeping those who came into contact with Duncan should not be traveling all around the country? I am sorry but they appear to he out of touch with the rest of the world. I don't think they listen to the news.

[notadmblnd]

13. It certainly makes one wonder how they got and keep their jobs

[underpants]

5. Unless I missed a step - she shouldn't have been anywhere in public

and she should have known that. If I was ID'ed as a possible I would be holed up and make plans for my family. Just saying.

[7wo7rees]

7. And so it begins. Circular firing squad. n/t

[joeybee12]

8. Doesn't give me much confidence that this nurse either didn't have common sense...

Or had been living in a vacuum these past several weeks and therefore thought nothing of flying...good for this judge to do what these healthcare "professionals" should have the sense to do without being told.

[Earth_First]

9. The stovetop range is hot.

Toaster oven + bathtub = no.

Roses = ouch.

Just a general reminder for those at Presbyterian.

[randys1]

10. What I am referring to is the ludicrous Idea that we NOT allow anyone who might be sick with ebola

to LEAVE areas where they can get NO healthcare but ONLY spread the disease more.

This would not apply to here in the US but I heard some rightwing dipshit congressman from TexASS say we cant allow anyone from anywhere to fly in here for a while, at least not anybody from those BLACK countries.

[roamer65]

12. Time for true mandatory quarantine. N/t

Also time for harsh penalties if you break it. Infected persons endanger the lives of close family and many others when they disregard common sense infectious disease guidelines.

[Mike Daniels]

70. Agreed. Duncan's family didn't follow common sense now they have a mandatory quarantine

If people are going to willingly put the larger population as risk because they can't be inconvenienced to self-quarantine themselves then more draconian measures may be needed.

Of course it didn't help that NBC's medical expert decided that she could ignore a quarantine order just so she could get high-end take-out.

[SidDithers]

14. The CDC also hasn't communicated that it's a bad idea to stab yourself in the eye with a fork...

But I'd guess that most people, and certainly all health-care professionals, might be able to figure that one out on their own.

Does a nurse really need to be told "Don't travel if you've recently treated someone who died of Ebola, one of your colleagues has been diagnosed with Ebola, and you maybe aren't feeling that well "?



Sid

[KamaAina]

15. DUzy!

[LisaL]

18. But CDC thought it was fine for this woman to fly with a fever.

She reportedly called CDC and asked them.
And they said it's not problem, fly away.

"CBS News Medical Correspondent Dr. John LaPook reports that Vinson called the CDC several times before boarding the plane concerned about her fever and was told she was OK to board."

http://dfw.cbslocal.com/2014/10/15/ebola-patient-traveled-day-before-diagnosis/

[dixiegrrrrl]

22. She had a 99 degree fever and hopped on a plane.

Maybe the very first sign of Ebola is a desire to go for a plane ride?

[LisaL]

28. CDC said it was fine for her to do it.

[uponit7771]

33. The CDC cleared her for travel after she called them multiple times

[Fumesucker]

42. But the CDC would tell you if you called that stabbing yourself in the eye with a fork..

Is a bad idea.

[YOHABLO]

16. We live in the United States of STUPID!!

[riverwalker]

17. So everyone who cares for an Ebola patient

can't travel for 21 days after caring for the patient?

sign me up

[LisaL]

20. She reportedly called CDC, and they told her it was fine for her to board with a fever.

[LisaL]

24. Better believe it.

It's being reported in msm. CDC confirmed it. They allowed her to go on the trip. Later on the article it says they allowed her to go back despite her fever.

"But the CDC has now confirmed that it gave Amber Vinson permission to make a trip to Cleveland."

http://www.wfaa.com/story/news/health/2014/10/15/second-dallas-hospital-worker-diagnosed-ebola/17290677/

[liberalhistorian]

25. I agree, I don't believe them at all, either,

I don't believe the CDC told her it was okay to fly. I don't believe she even called them; and I don't believe that, if she DID call them, that they gave her the green light. I think the nurse and the hospital are covering their asses here, trying to make the CDC the scapegoat in what was an EPIC fail on the part of the nurse and the hospital.

[LisaL]

26. Do you believe CDC?

They confirmed both things.
They allowed her to go on the trip and allowed her to fly with a fever.

"It was later confirmed that the CDC gave Vinson permission to get on the plane because she was showing no other symptoms of the virus, and her temperature didn't reach the threshold of 100.4 degrees."

http://www.wfaa.com/story/news/health/2014/10/15/second-dallas-hospital-worker-diagnosed-ebola/17290677/

[liberalhistorian]

34. WOW. I do NOT

understand where they were coming from, then, that makes no sense. I would think that they'd have known the lengthy incubation period and would have refused all travel, if not have them in quarantine. Jesus, that's frightening.

[riderinthestorm]

40. Welcome to the "CDC is incompetent freak out group"...

Now you understand those of us with our hair on fire about the CDCs incompetence.



Welcome to the club...

[tblue37]

65. The person she spoke with gave the advice based *entirely* on a chart

that specified a 100.4 degree fever as the level to be concerned about. But elsewhere on the CDC site it says those who have been exposed should not travel. I think the person at the CDC giving her advice confused general guidelines for people merely *coming from a part of the world with Ebola cases* with the guidelines for those *with known exposure* from being in contact with a *symptomatic* Ebola victim, which she and the other health care workers had been.

Obviously someone reading from a chart to offer advice is not someone with any actuall expertise in the matter. The CDC needs to staff a dedicated Ebola hotline with someone who actually *knows* something about the virus and how it spreads.

[cwydro]

69. Crazy to have a specific fever temp.

My regular body temp is ALWAYS 97.6, so 99.5 would be a pretty good spike for me.

I would think ANY fever in a person who has been exposed would be cause for concern.

[Warren DeMontague]

43. they were probably too busy coming up with their newest apology or mass-calming reassuring quote

to actually think this thing through.

Oops.

[ctaylors6]

30. CDC has confirmed gave green light for her to fly (link)

Link: http://www.huffingtonpost.com

It's being widely reported in Dallas and being picked up nationally

[Warren DeMontague]

41. Wow, another win for the CDC. The same home of the "experts" who tell us that restricting visa

travel from 3 countries in any way, shape, or form would be an unimaginable tragedy and impossible logistical feat.

[liberalhistorian]

23. Jesus H. Christ

on a cracker raft, do none of these fucking idiots have any goddamned common sense? Why in the HELL should you need to be told your travel is restricted when you've been directly exposed to a deadly, usually fatal, disease? Especially if you're a goddamned medical professional????????? Really? Seriously? Do they need to be fed by hand and tucked into bed at night, too????????????

[ecstatic]

48. Remember, up until Pham's diagnosis, the workers weren't even considered to be

at risk of catching ebola, since they were supposedly following CDC protocols.

[Skittles]

27. do they not educate themselves?

who waits for "management" to tell them what to do, besides teabaggers?

[LisaL]

29. Her tripped was approved by CDC.

Even after she got the fever, they allowed her to get onto the plane.

[Skittles]

31. I would not have even asked for permission -I would not go

it is ridiculous - makes no sense at all

[kestrel91316]

36. Apparently nurses do. And they get very offended if you point out that this might just smack of

laziness and unprofessionalism.

[goldent]

38. Turns out she was being more cautious than the CDC - incredible!

[kestrel91316]

35. If they failed to cram written advice down their freaking throats while screaming it in their ears,

they showed a lack of understanding of just how stupid people can be. CDC assumes people will behave intelligently. This is a very bad assumption.

Judge Jenkins again makes a lot of sense. And at least if HE says "stay put" people will listen. The locals may very well just be deliberately ignoring everything CDC tells them. Which is something I predicted.

[goldent]

39. Turns out the CDC might be the stupid one

“This nurse, Nurse Vinson, did in fact call the CDC several times before taking that flight and said she has a temperature, a fever of 99.5, and the person at the CDC looked at a chart and because her temperature wasn’t 100.4 or higher she didn’t officially fall into the category of high risk.”

Sadly there is too much blind trust in what the CDC has been saying, and appears they are seriously letting us down.

[kestrel91316]

44. She didn't meet the criteria for a body temperature of concern.

Can you cite the scientific data that shows that a temp of 99.5F is due to Ebola frequently enough to justify people not flying with it?

CDC uses scientific data and, you know, EVIDENCE to arrive at its guidelines. That's why epidemiologists are crack statisticians.

Monday morning quarterbacking is SOOOOO easy. And it makes not-so-smart people look smart to those who really aren't paying attention.

[Fumesucker]

45. You sure changed your tune quickly

You wanted to crucify the poor nurse for even thinking about flying just a few minutes ago.

[goldent]

46. The CDC director is the one doing Monday morning quarterbacking

He now says the nurse was given incorrect advice, given the circumstances.

[Yo_Mama]

49. Do you need to seek treatment for whiplash?

One moment you're claiming that the nurse is unbelievably stupid for not following CDC advice, and the next moment you're claiming that CDC gave the correct advice, except that the top guy at CDC then "oops" contradicted that advice.

There's stupidity here, but it's not the nurse's. Either the CDC's advice to the nurse was correct in the first place and Frieden's statement was wrong (and thus there was no scientific basis for the CDC deciding to contact all the passengers after the nurse tested positive), or Frieden was right and the guidance given on the website was wrong (but why is it there if it wrong?) and the nurse is unbelievably stupid, but then so is the CDC for not giving them guidance not to travel in the first place!

What's going on is that the CDC is repetitively blaming HCW when the HCW follow CDC's advice and it doesn't work out in practice. That's a problem.

[laundry_queen]

50. Yeah

but if you are someone who just spent a week or so caring for someone with Ebola, and the first symptom is a fever and you are self monitoring, I know *I* personally wouldn't be all, "oh, it's ONLY 99.5, so it must not be Ebola and I'm SURE it's perfectly SAFE to fly." WTF? Fevers can escalate quickly. Oh, what the hell, if I was self monitoring after being a caregiver to someone with Ebola, I'd send my kids off to their grandparents and I'd isolate myself completely for 21 days, fever or not. But that's because I give a shit about others. I don't understand what this nurse was thinking, and I don't understand why the CDC has been SO incredibly nonchalant about all of this.

[VanillaRhapsody]

54. She was likely in denial....

[laundry_queen]

55. Probably

which is why it's SO important to make sure that professionals who treat patients with Ebola are trained properly and extensively - and that training SHOULD include some education and/or counselling on acknowledging one's own penchant for denial under these kinds of circumstances.

[VanillaRhapsody]

56. Even Dr Nancy violated her own voluntary quarantine....

[laundry_queen]

58. I know

which is why I'm not a fan of 'voluntary' in these circumstances. There's always one or two people who, if not in denial, instead think they are too special to have to comply. Although I don't know how you could possibly make it 'mandatory'. There is no easy solution here.

[LisaL]

62. Dr. Nancy doesn't have Ebola.

Therefore not infectious. Yet she was put under mandatory quarantine.
The nurse actually was infected with Ebola. CDC directly clearly suspected that more nurses will get Ebola, and said as much. Yet CDC allowed her to fly.

[VanillaRhapsody]

64. yet

[LostInAnomie]

37. These kind of people are why we have warnings on Windex bottles...

... telling us to not spray it into our eyes.

How is it possible for people working in health care to be this stupid? It's not like Ebola is some mystery disease that no one has ever heard of. It has literally been in the news for months. They were at ground zero for the biggest medical news of the year. They had to know fully how deadly and infectious this disease is. It should be common sense for anyone with an 7th grade education to know that if you have been exposed to one of the worst diseases there is, you should not go on mass transportation.

[Yo_Mama]

47. How is it possible for the CDC to be this stupid?

Look, if we are going to castigate medical personnel for following the CDC's direct advice after calling and asking a direct question, then we might as well hang it up now and all dive into our bunkers. CDC is in charge of making these rules. That's their role, their responsibility. They need to start fulfilling that role. They aren't now, and they haven't been.

[Fumesucker]

51. It sucks how many people want to kick down and kiss up

All this bashing of low level workers who are risking their lives dealing with literal crap while hampered and harassed by management that is actively evil is starting to tick me off.

[LostInAnomie]

53. I'm just not buying it.

This nurse IS a professional and she was originallt told not to travel by the CDC. She knows how diseases spread and what to look out for. So, once she starts to develop a fever, instead of going to a doctor, what does she do? She has a phone conversation with someone with no real ability to diagnose her. That is absolutely irresponsible for a medical professional.

[Yo_Mama]

57. They were never told not to travel by CDC. They had no restrictions on movement whatsoever.

She called the CDC to ask the direct question. That's as responsible as you can get.

If she had waited and gone to a local hospital, they would have called the CDC. That's the protocol in these cases. No one gets tested unless the CDC approves the test first.

CDC is and has been in control of this entire process. Here's the guidance from their website:
http://www.cdc.gov/vhf/ebola/hcp/interim-guidance-specimen-collection-submission-patients-suspected-infection-ebola.html

The following steps should be used in submitting samples to CDC.

Hospitals should follow their state and/or local health department procedures for notification and consultation for Ebola testing requests and prior to contacting CDC.
NO specimens will be accepted without prior consultation. For consultation call the EOC at 770-488-7100.
Contact your state and/or local health department and CDC to determine the proper category for shipment based on clinical history and risk assessment by CDC. State guidelines may differ and state or local health departments should be consulted prior to shipping.
Email tracking number to [e-mail].
Do not ship for weekend delivery unless instructed by CDC.

It's still the same way:
http://www.statesmanjournal.com/story/news/health/2014/10/15/woman-isolated-salem-hospital-ebola-concerns/17325883/

[LisaL]

59. I don't know.

Their director comes out and says other nurses are quite possibly infected.
Yet they allow a nurse to fly with a fever. Because her fever hasn't reached some magic number they somehow decided it had to reach.
So I can't understand how it is possible for the CDC to be so stupid.

[Yo_Mama]

66. There are reasons why they might have wanted her to return to Dallas

You wouldn't want a possibly Ebola-infected person renting a car and driving for hours and hours, potentially becoming ill en-route and being involved in a car accident. The nightmare possibility is that HCW run into a person in trauma who needs emergency medical assistance WITHOUT knowing that the person is infected.

Their real choice was between telling her to get on that flight or telling her to seek care in a local hospital, which ran a risk of starting another set of exposures.

Nurses don't have charter planes.

[calimary]

52. Not any sort of expert here, but why aren't those who've had direct exposure to

a gravely ill Ebola patient - put on a no-fly list?

[morningfog]

60. Because it is unecessary. If someone is infected, the viral load builds over a long period of time.

The fever is the first symptom. It comes early and the viral load is low. The person is not very contagious. Essentially, they are theoretically contagious. Nor are they spreading their bodily fluids everywhere. It takes days to reach the point were the viral loads are high and the bodily fluids are spewing. Most infections occur just before or just after death. There is no evidence of infection by someone with only a fever.

[LisaL]

61. Not according to CDC director, who claimed these people should not be flying.

[morningfog]

63. He is now, sure. This is an optics change. He got reamed in the media.

No one was at risk. It is why they gave the okay.

[bklyncowgirl]

68. Optics count. Impressions count. Sometimes even more than facts.

You are very likely right. The problem is, however. reassuring as these facts are they will fall on deaf ears if the people uttering them appear to be doing things that seem stupid and even reckless to the average person. That woman had no business getting on that plane.

[tblue37]

67. As I mentioned in an earlier post, the CDC person who approved her flying

seems to have confused two different sets of guidelines. The chart that person read from pertained to people in general who have been in the general vicinity of Ebola cases, not people (like health care workers) who have had direct exposure to symptomatic individuals with the disease. The guidelines for *that* group are more rigorous:

Controlled movement

Controlled movement requires people to notify the public health authority about their intended travel for 21 days after their last known potential Ebola virus exposure. These individuals should not travel by commercial conveyances (e.g. airplane, ship, long-distance bus, or train). Local use of public transportation (e.g. taxi, bus) by asymptomatic individuals should be discussed with the public health authority. If travel is approved, the exposed person must have timely access to appropriate medical care if symptoms develop during travel. Approved long-distance travel should be by chartered flight or private vehicle; if local public transportation is used, the individual must be able to exit quickly.

[Fumesucker]

71. Sounds like a training problem at the CDC

Whoever is on that phone really shouldn't have to be looking up this stuff, they should know it and then double check with the database to be sure..

In case of conflict between what they have learned and what's on the database the CDC phone operator should then call an actual expert.

The problem I see here is that no one who actually knows the stuff inside and out is answering the phone.