5 ms·

But this article is already out of date. Only hours after this article was published we learn that the second nurse to test positive was allowed to fly commerci

But this article is already out of date. Only hours after this article was published we learn that the second nurse to test positive was allowed to fly commercial a day before her diagnosis and after the first nurses diagnosis. We definitely can't compare our response to Nigeria's.

anigbrowl 12y ago
With the CDC's OK because her fever was only 99.5 degrees F instead of 100.4. What idiot at the CDC made that decision? Did nobody, including the nurse, consider the idea that the fever might progress and that it would be better to be safe than sorry? When did so many people become so deficient in common sense?! http://dfw.cbslocal.com/2014/10/15/ebola-patient-traveled-day-before-diagnosis/ http://dfw.cbslocal.com/2014/10/15/ebola-patient-traveled-da...
- ceejayoz 12y ago
  According to Wikipedia, 99.5 isn't a fever. http://en.wikipedia.org/wiki/Fever http://en.wikipedia.org/wiki/Fever > characterized by an elevation of body temperature above the normal range of 36.5–37.5 °C (97.7–99.5 °F)
  - hga 12y ago
    If you've nursed a terminal Ebola patient 99.5 may indeed not technically be a fever, but it's something you should pay attention to. Heck, more to the point, she should know her normal temperature range at the various times in the day and if that's a fever for her. In the morning it would be a fever for me, I run a bit cool. Also note even the professional WelchAllyn units are not 100% accurate, they're rated for 0.2 F plus or minus (I bought one not long ago after my old el-cheapo BD one died and Amazon reviews revealed today's el-cheapo ones are by and large worthless. Heck, 3M even created a new consumer brand, no doubt to avoid brand damage to BD).
    - diltonm 12y ago
      In bootcamp I once had a temperature around 97 something. The doctor took it with two different thermometers not believing it. I felt fine. Apparently that temperature's not considered abnormal: http://www.webmd.boots.com/a-to-z-guides/normal-body-temperature http://www.webmd.boots.com/a-to-z-guides/normal-body-tempera...
      - beagle3 12y ago
        While now my temperature is a normal 36.2 celsius, for years I was oscillating 35.0-36.0, feeling fine. Every doctor or nurse the saw me said it was unusual, but none ever thought it was cause for alarm.
  - anigbrowl 12y ago
    I understand that. I have a slightly elevated body temperature myself. But the nurse, who had been treating a patient known to have Ebola, called the CDC to advise them that she had a temperature (presumably relative to her usual temperature). It seems to me that if we're dealing with an unusually high-risk situation, it's better to err on the side of caution, no?
    - mercer 12y ago
      Agreed. it's not like it would cause significant harm/cost at this point to isolate someone who is close to having a fever, and was in direct contact with Ebola.
- ewoodrich 12y ago
  Part of the reason for that threshold is that Ebola is only transmissible (based on current evidence) when the patient is "symptomatic". If the threshold was set too low, then the screening process would have too many false positives and potentially overburden it beyond being effective at all.
  - anigbrowl 12y ago
    Cost of a false positive here would have been a nurse who was inconvenienced. Cost of a false negative is at a minimum the time and expense of contact-tracking 132 people who flew with her, the cost to the airline of taking the plane out of service (which they've already done), and a severe drop of public confidence in the CDC. The pane made 5 more flights before it was taken out of service: http://www.latimes.com/business/la-fi-frontier-airline-ebola-patient-20141015-story.html http://www.latimes.com/business/la-fi-frontier-airline-ebola... Now, the chances that anyone else on the same flight got infected is very very low, close to zero. That's even more true for the people who took other flights on the same plane, even the people who were sitting in the same seat that she sat in - though it's non-zero, as I doubt the airline disinfects the armrests and fold-down trays after every single flight. But just doing the contact tracking and being prepared to field telephone and email inquiries from all the other people who traveled on that plane with and after the nurse did is going to consume a bunch of CDC resources that could be better spent elsewhere. Meanwhile, it seems that staff at the hospital were not wearing adequate protective gear for the first 2 days after Duncan was admitted until they got a positive blood test for Ebola: http://thescoopblog.dallasnews.com/2014/10/presbyterian-workers-wore-no-protective-gear-for-two-days-while-treating-ebola-patient.html/ http://thescoopblog.dallasnews.com/2014/10/presbyterian-work... False positives are bad but IMHO they're a lot cheaper than false negatives. When dealing with the limited subset of people who had contact with known Ebola carrier at the Texas hospital (a total of 76 medical personnel AFAIK), the slight economic cost of limiting travel and monitoring all of them for a few weeks seems low compared to the new situation.
    - JoeAltmaier 12y ago
      If its only one, sure. How many people on that plane had temperatures around 99? Half a dozen? From flu or hot coffee or too much sun? If half a dozen people are kept off of every plane and quarantined, that's thousand of people a day. That's an overburdened health care staff. I have more sympathy for the problem.

anigbrowl 12y ago

With the CDC's OK because her fever was only 99.5 degrees F instead of 100.4. What idiot at the CDC made that decision? Did nobody, including the nurse, consider the idea that the fever might progress and that it would be better to be safe than sorry? When did so many people become so deficient in common sense?! http://dfw.cbslocal.com/2014/10/15/ebola-patient-traveled-day-before-diagnosis/ http://dfw.cbslocal.com/2014/10/15/ebola-patient-traveled-da...

ceejayoz 12y ago
According to Wikipedia, 99.5 isn't a fever. http://en.wikipedia.org/wiki/Fever http://en.wikipedia.org/wiki/Fever > characterized by an elevation of body temperature above the normal range of 36.5–37.5 °C (97.7–99.5 °F)
- hga 12y ago
  If you've nursed a terminal Ebola patient 99.5 may indeed not technically be a fever, but it's something you should pay attention to. Heck, more to the point, she should know her normal temperature range at the various times in the day and if that's a fever for her. In the morning it would be a fever for me, I run a bit cool. Also note even the professional WelchAllyn units are not 100% accurate, they're rated for 0.2 F plus or minus (I bought one not long ago after my old el-cheapo BD one died and Amazon reviews revealed today's el-cheapo ones are by and large worthless. Heck, 3M even created a new consumer brand, no doubt to avoid brand damage to BD).
  - diltonm 12y ago
    In bootcamp I once had a temperature around 97 something. The doctor took it with two different thermometers not believing it. I felt fine. Apparently that temperature's not considered abnormal: http://www.webmd.boots.com/a-to-z-guides/normal-body-temperature http://www.webmd.boots.com/a-to-z-guides/normal-body-tempera...
    - beagle3 12y ago
      While now my temperature is a normal 36.2 celsius, for years I was oscillating 35.0-36.0, feeling fine. Every doctor or nurse the saw me said it was unusual, but none ever thought it was cause for alarm.
- anigbrowl 12y ago
  I understand that. I have a slightly elevated body temperature myself. But the nurse, who had been treating a patient known to have Ebola, called the CDC to advise them that she had a temperature (presumably relative to her usual temperature). It seems to me that if we're dealing with an unusually high-risk situation, it's better to err on the side of caution, no?
  - mercer 12y ago
    Agreed. it's not like it would cause significant harm/cost at this point to isolate someone who is close to having a fever, and was in direct contact with Ebola.
ewoodrich 12y ago
Part of the reason for that threshold is that Ebola is only transmissible (based on current evidence) when the patient is "symptomatic". If the threshold was set too low, then the screening process would have too many false positives and potentially overburden it beyond being effective at all.
- anigbrowl 12y ago
  Cost of a false positive here would have been a nurse who was inconvenienced. Cost of a false negative is at a minimum the time and expense of contact-tracking 132 people who flew with her, the cost to the airline of taking the plane out of service (which they've already done), and a severe drop of public confidence in the CDC. The pane made 5 more flights before it was taken out of service: http://www.latimes.com/business/la-fi-frontier-airline-ebola-patient-20141015-story.html http://www.latimes.com/business/la-fi-frontier-airline-ebola... Now, the chances that anyone else on the same flight got infected is very very low, close to zero. That's even more true for the people who took other flights on the same plane, even the people who were sitting in the same seat that she sat in - though it's non-zero, as I doubt the airline disinfects the armrests and fold-down trays after every single flight. But just doing the contact tracking and being prepared to field telephone and email inquiries from all the other people who traveled on that plane with and after the nurse did is going to consume a bunch of CDC resources that could be better spent elsewhere. Meanwhile, it seems that staff at the hospital were not wearing adequate protective gear for the first 2 days after Duncan was admitted until they got a positive blood test for Ebola: http://thescoopblog.dallasnews.com/2014/10/presbyterian-workers-wore-no-protective-gear-for-two-days-while-treating-ebola-patient.html/ http://thescoopblog.dallasnews.com/2014/10/presbyterian-work... False positives are bad but IMHO they're a lot cheaper than false negatives. When dealing with the limited subset of people who had contact with known Ebola carrier at the Texas hospital (a total of 76 medical personnel AFAIK), the slight economic cost of limiting travel and monitoring all of them for a few weeks seems low compared to the new situation.
  - JoeAltmaier 12y ago
    If its only one, sure. How many people on that plane had temperatures around 99? Half a dozen? From flu or hot coffee or too much sun? If half a dozen people are kept off of every plane and quarantined, that's thousand of people a day. That's an overburdened health care staff. I have more sympathy for the problem.