<p>@iglooo, are you really seriously about placing all of the blame for this public health debacle on the patient and his family?</p>
<p>You, a private citizen, may not be well informed about the countries involved in the Ebola epidemic, but ER professionals who had apparently just been through a training session on it, for heaven’s sake, certainly OUGHT to be. That’s their job. </p>
<p>It would seem that part of the health apparatus–the contact-tracing–has worked well, but a lot of the rest of it has fallen down on the job. As far as the people in the apartment, it is hard to avoid the conclusion that no one really gave a damn about them as individuals. Much more publicity and brouhaha about cleaning and disinfecting schools where no infectious person is known to have set foot. Including the governor. (Which is not inappropriate, but where was his concern for the family and neighbors? Why wasn’t he proudly talking about the precautions being taken for THEM?) It sounds as if the CDC or someone made an attempt to get a contractor in there, but no one would go at first. But leaving them there for 4 days? Reportedly, Louise made an effort to clean the apartment with bleach, and has simply stayed out of the bedroom and bathroom. I really feel for the horror they are going through in there. At least it appears that Anderson Cooper’s interview has woken some people up.</p>
<p>Yes, the nurse and the hospital should have been more vigilant. No doubt about that. But all this would have been much simpler if the patient told straight away that he was in direct contact with an Ebola virus who later died.</p>
<h1>239 the way I understand it, if all 4 who are in quarantine together make it to Oct 19 without symptoms, then they are all out of danger.</h1>
<p>I think if one person gets sick before then, let’s say on Oct 10, the sick person goes into the hospital isolation ward and the remaining three get their quarantine reset to another 21 days (to Oct 31, in that scenario).
Maybe one of our MDs can correct me if I’m wrong about that.</p>
<p>“They just announced on NBC that officials in Liberia are are pressing charges against Duncan because he lied on his health form.”</p>
<p>I have mixed feelings about this. On the one hand, if it is indeed their law, they can do this. The law was put in place to deter such behavior by creating a way to punish such behavior and therefore to protect the people not only in Liberia, but in the US, eventually. On the other hand, we are talking about Liberia, and I’m not confident that he will not get a death sentence for this - if he survives the disease.</p>
<p>And what if he knowingly has infected people here in the US and Belgium and some of them die? Should he not be held fully accountable for killing them? </p>
<p>I have seen pictures of Red Cross folks delivering boxes of food in front of the apartment.</p>
<p>Add to the more scarier things in Dallas list (sort of aluded to in the tropical diseases category): West Nile. Lots of carrier mosquitoes in the area. Can be fatal or lead to paralysis and/or neurological problems.</p>
<p>What is the law for knowingly infecting people with AIDS?</p>
<p>Why are we talking about other scary things in Dallas? A new scary thing is always the most scary IMO. Simply because i could doi of West Nile doesn’t make me feel safe from Ebola.</p>
<p>“And what if he knowingly has infected people here in the US and Belgium and some of them die? Should he not be held fully accountable for killing them?”</p>
<p>Possibly. It depends if he is going to be charged with and found guilty of any crimes. The question then is if his conduct was intentional.</p>
<p>In this country, not sure. That would vary by state. </p>
<p>However, I am talking about Liberia. If knowingly killing someone warrants the death penalty under their laws, then they can institute said punishment if they want.</p>
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<p>Lying about whether one has had contact with people known to have a specific disease, in order to get on an airplane, is intentional. </p>
<p>What is still not being discussed, is that while he did mention at the hospital that he was from an affected area, he never told anyone that he was in direct contact with ebola patients. So even if you blame the hospital for not reacting to the information they had, I can’t believe they wouldn’t have reacted much more aggressively if he specifically told them that he was definitely exposed to ebola.</p>
<p>I have been at work and am out of the loop on whatever has happened today with regard to news of the family and conditions there.</p>
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<p>A nurse doesn’t need to diagnose ebola to make sure that the doctors know it’s appropriate to screen for it and to get the ball rolling for an isolation room. You just don’t check the box and think all is well. You FOLLOW THROUGH. Yes, the doctors should have read her assessment. That doesn’t mean she doesn’t have a responsibility to make sure that proper notice is taken of something so important. “It’s not my job to spoon feed the residents” does not cut it when the health of the entire community is at stake.</p>
<p>So why didn’t this nurse do that? Maybe she didn’t realize Liberia is in West Africa and one of the hot spots. Maybe she is incompetent or so overworked she just didn’t absorb what the patient told her. I doubt she just didn’t care or was lazy because it is in the interest of that nurse who is in close contact with a patient to know if SHE has now been exposed to the disease by virtue of this contact! Whatever the reason for the miscommunication, I doubt it was due to apathy. </p>
<p>The hospital, as I’ve said before, is guilty of a huge mistake. That, however, does not mean the patient himself cannot share a big portion of culpability here. If the reports are true that he had direct contact with a dying ebola patient before he left Liberia, the fact that did not make that clear is unconscionable. I remain unconvinced that he wasn’t completely aware that he had had direct contact with an ebola patient when he went to Presbyterian Hospital. Saying he had traveled from Liberia was NOT enough and I don’t believe for a moment that he wasn’t aware that it was his responsibility to say it. Had he said, “I’m really worried you aren’t taking this seriously enough. After all, my country is in the middle of the ebola epidemic and I just the other day literally carried a dying woman into the hospital.” I think we all know that those words would have had that entire hospital on task in minutes. </p>
<p>In situations like this, there doesn’t have to be only one person to blame. There seems to be plenty of blame to spread around among several people. I really feel bad for all the dedicated and caring professionals who work at that hospital. I know A LOT of them, and most are intelligent, conscientious, knowledgeable, experienced, and very very good at what they do. Unfortunately for the actions of but a few, the whole institution is and will continue to be characterized so very badly.</p>
<p>You are trying to make a case for which I think the answer is already implicit. </p>
<p>If a person knows he has been exposed several times to a disease transmitted by contact by touching infected parties, then knowingly has contact with other people without protection or without warning them AFTER one has that knowledge that is clearly negligent and intentional, regardless of what he is thinking. He has callous disregard for the lives of others knowing he carried such disease and he intentionally exposed them. Note - he carried his relative up stairs, and god nows who he might have shaken hands with etc. </p>
<p>That would be like me knowing that if I have a killer poison on my hands, then it is not murder if I disregard that fact and knowingly touch people. What I am thinking is not relevant since I know I am a killer in waiting just by touching people, and then I knowingly touch them.</p>
<p>I know the law would have a field day here, but they would not want me on that jury.</p>
<p>If it gives anyone any measure of comfort, my business services hospitals, and we’re out on the east coast. All my people are reporting in that there are cleaning measures and training going on with everyone for ebola and how to distinguish it from the flu season that is coming up. </p>
<p>When I was a school teacher way back when, I used to give my students (majority were white kids of blue collar parents) a basic geography test. I kid you not when I say that the majority of them could not identify THE UNITED STATES on a world map! For most of the CC community who are very well educated and the parents of some brilliant kids, this may seem hard to believe. I would see “USA” written in the middle of the Pacific Ocean, or in Australia, etc. Many coudn’t identify any of the continents correctly.</p>
<p>RNs in Texas (well, in all states actually) come from a wide variety of backgrounds. You can be a RN with an associates degree or Bachelor’s degree. You can be brilliant from a medical perspective, with loads of common sense, knowledge of medications, anatomy and pathology, etc. You can also get your RN while knowing very little about geography, politics, history, government, literature, etc. I’m really starting to wonder if the intake nurse perhaps didn’t know Liberia was in Africa, much less in West Africa where most of the ebola cases are. He/she may have checked a box without knowing the implications of that choice.</p>
<p>I say this NOT as an excuse, but as a plausible explanation. It doesn’t mitigate the liability at all, but it offers an explanation that actions may have been due to ignorance rather than a willful disdain for the well being of the patient and community at large.</p>
<p>There are many ideas about why the patient checked NO on the boxes and didn’t inform hospital staff that his risk profile might go beyond just originating in Liberia: a calculated play to get to the US for health care, callous disregard with full knowledge, willful ignorance, superstition, culture, lack of understanding about the disease, misplaced optimism . . . the list goes on and on. In the end what concerns me more than which it was in his case is that a screening system exists that is susceptible to all those forces and more. If you can’t ask someone what seems like a simple question and get a factual answer then what good is it really?</p>
<p>I do agree he should have been more forth coming, but I don’t get the logic of thinking it could have been a calculated play for US healthcare. Because he left the hospital without it. If he came here knowing he might well have it, starts to get ill, leaving without the necessary care seems illogical.</p>
<p>Plus, it’s fairly clear the trip was already planned. He had family here ,and he quit his job before the exposure (maybe he wanted to get away because of the epidemic, but that’s a different argument.)</p>