Quotes of the day

The family of Thomas Eric Duncan, the Liberian man who died Tuesday of Ebola after arriving in Dallas late last month, said they are filled with “sorrow and anger” and want an impartial probe into “all aspects of his care” after President Obama last week admitted “missteps” in the US response…

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[W]hile doctors desperately tried to save Duncan’s life, his death stands in stark contrast to the plight of several Americans, including aid workers and doctors, who have survived the illness after being treated in the US…

An ethical debate has emerged over a decision that some say was too long delayed to try an experimental drug on Duncan, especially as he was given a different serum than the one used on the American victims who survived. The makers of ZMapp, the experimental Ebola antibody serum that may have helped two US aid workers survive the illness, said it had run out of the drug and that it will take months to make more.

Instead, doctors gave Duncan an antiviral drug used for other illnesses, but which had never been tested for Ebola in humans. Medical experts say counterproductive side effects likely kept doctors from giving Duncan the drug earlier, only administering it after it became clear his condition was worsening.

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Texas officials continue to monitor 10 people who had direct contact with him while he was symptomatic, as well as 38 others who may have had contact. None have shown symptoms of the disease up to this point.

The incubation period of Ebola is a maximum of 21 days, with symptoms commonly beginning to present eight to 10 days after exposure. If Duncan passed the virus onto anyone else, that would likely become evident this week.

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If any show signs of a fever, or other symptoms, health officials plan to immediately isolate and test those individuals for the virus.

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Twice as many Americans are very concerned about an epidemic in the United States today than were that worried in August, when Ebola emerged as a threat – but in western Africa. Then, just 17% were very concerned that Ebola could spread to the U.S. and become an epidemic here. Now that there are cases in the United States, a third are very concerned.

There is especially high concern among African-Americans. 40% of them say they are very concerned about the possibility of an epidemic here. Some of the largest increases in concern comes from senior citizens (from 13% very concerned in August to 40% today).

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Twenty-two percent of Americans say they worry about getting the Ebola virus, matching or exceeding the number of U.S. adults who worried about contracting the H1N1 virus throughout its 2009 outbreak, despite the higher prevalence of H1N1 in the U.S…

While there is no evidence that any person has contracted the Ebola virus while in the United States, Americans are not optimistic that the country will avoid a rendezvous with the disease in some form, although most do not expect a major outbreak. Just 12% say Ebola will not strike the U.S. Meanwhile, 65% say there will be a minor outbreak, and nearly a fifth say we will have either a major outbreak (9%) or a crisis (9%). These numbers are largely in line with public forecasts regarding the bird flu at the time, a disease that never materialized in the U.S.

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Federal officials said Wednesday that they would begin temperature screenings of passengers arriving from West Africa at five American airports, beginning with Kennedy International in New York as early as this weekend, as the United States races to respond to a deadly Ebola outbreak.

Travelers at the four other airports — Washington Dulles International, O’Hare International, Hartsfield-Jackson International and Newark Liberty International — will be screened starting next week, according to federal officials.

The screenings, which will include taking the passengers’ temperatures with a gun-like, noncontact thermometer and requiring them to fill out a questionnaire after deplaning, will be for people arriving from Liberia, Sierra Leone and Guinea, the three countries hardest hit by the epidemic…

There have been calls to ban travel from the affected countries altogether, but senior administration officials said that would be counterproductive, because it would harm the international effort to quell the disease in West Africa, where it is raging out of control. Further spreading of the disease in Africa would serve only to increase the risks to Americans.

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Some researchers have called the scanners reassuring, and not much more.

Checking body temperature isn’t a sure-fire way to find individuals infected with Ebola. People can carry the virus for up to three weeks before showing symptoms, and are not contagious during that period. The patient in the US case, Thomas Eric Duncan, was reportedly asymptomatic when he travelled from Liberia to Dallas.

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In a guidance paper produced by the Centers for Disease Control and Prevention for airport and public health officials, the agency lists what it sees as problems with the devices, including cost, lack of precision, need for frequent calibration and maintenance and training requirements. Testing efficacy to judge the scanners write large is difficult because of the many and changing models available.

While such scanners can be good at ruling out people without fevers, the CDC said, they have a wide and varying range of efficacy at finding people with fevers depending on environmental conditions and even the age of the person being scanned. The FDA approved the devices for use only with more conventional methods of taking someone’s temperature, such as a mercury thermometer or color-changing strips.

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The World Bank’s assessment said the economic impact of Ebola is already serious in the three countries and could be catastrophic if it becomes a more regional health crisis. The CDC said last month that unless efforts to curb the outbreak are ramped up significantly and quickly, the disease could infect up to 1.4 million people by mid-January in two nations, Sierra Leone and Liberia, alone…

It is far from certain that the epidemic will be contained by the end of the year, so the report estimated the economic costs of two scenarios as the battle against the disease continues. The report estimated that the economic impact could top $9 billion if the disease is rapidly contained in the three most severely affected countries, but could reach $32.6 billion if it takes a long time to contain Ebola in the three countries and it spreads to neighboring nations.

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I and many others are not comfortable with the idea of bringing infected individuals into our midst when we can readily treat them elsewhere and happily receive them back once the infectious danger has passed.

When one does a logical benefit-to-risk analysis, it is clear that the worst things that could happen by intentionally bringing this dangerous disease to America are far worse than the best things that could happen. Some say if we bring infected individuals here, it will accelerate research endeavors and a potential cure or effective vaccination. Others say that not bringing infected citizens back demonstrates an insensitivity toward wonderful people who risk their lives for others. I am sympathetic to these arguments, and if we did not have safer alternatives, they would convince me.

Perhaps we should be concentrating on stopping the spread of Ebola in Africa and eradicating it from Earth. Like the war on terrorism, we should fight it elsewhere to decrease the likelihood of needing to fight it here. African lives are every bit as valuable as lives in America or anywhere else, and this humanitarian crisis has enormous health implications for the whole world. If, as some officials say, bringing infected individuals back here expedites the acquisition of knowledge that could lead to a cure, as all components of the disease can be more carefully studied, why not transport more researchers and facilities to the heart of the epidemic and dramatically accelerate the process?

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