<p>Yes, those numbers have been calculated and really relates to blood contact, bodily fluids, droplet and airborne transmission ability of the pathogens. The higher the R0 number the more likely the pathogen is airborne or survives well outside of the body. But they are not completely accurate. Hepatitis C and even Ebola have cases such that the mode of transmission is unknown (unconfirmed).</p>
<p>Thanks, frugal doctor. Are you thinking that these estimates are significantly off? Even if the R-0 number was found to be higher, if it climbed to >2 or 3, thats still not extremely high, yes? This suggests its 1.6-2 <a href=“Early Epidemic Dynamics of the West African 2014 Ebola Outbreak: Estimates Derived with a Simple Two-Parameter Model – PLOS Currents Outbreaks”>http://currents.plos.org/outbreaks/article/obk-14-0036-early-epidemic-dynamics-of-the-west-african-2014-ebola-outbreak-estimates-derived-with-a-simple-two-parameter-model/</a> and that the focus should be on epidemic control in Africa, to which we are all in agreement, I believe.</p>
<p>And Bay, even though Duncan has infected 2 people (or rather 2 were infected caring for Duncan) none of the other victims treated in the US have thus far contaminated anyone, so their values would be zero, if it works that way.</p>
<p>Other hospitals treating patients in US had heads up that patient was coming</p>
<p>“I understand that the “CDC” told her she could fly home. I don’t get how a RN with 2 degrees would even need to ask the question. I know it’s not PC to even lay a hint of blame at the nurse rather than bureaucratic ineptitude, but sorry, as a RN, I don’t see how this wasn’t TOTALLY obvious to her.”</p>
<p>I’m not a nurse and have no medical training, education and it’s totally obvious to me! </p>
<p>"That said, I can see some “CDC person” looking at their manual, “Okay, so your temp is not 100.4? Great, you’re good to go!” </p>
<p>No excuse. Dumb! </p>
<p>“They are saying that the staff person ok’d the nurse flying from Cleveland because her temp (99 something) was below the threshold (101 something) used at airport screenings, so felt it was ok.”</p>
<p>Does anyone know if she called the CDC before she left Dallas and flew to Cleveland? Or did she just call them regarding her trip home? </p>
<p>I believe she (a) didn’t have a temp or symptoms when she left Dallas and (b) didn’t know her colleague was ill (when she left on Friday she didn’t know this).</p>
<p>“I believe she (a) didn’t have a temp or symptoms when she left Dallas and (b) didn’t know her colleague was ill (when she left on Friday she didn’t know this).”</p>
<p>So I guess she didn’t contact anyone at CDC before she flew from Dallas to Cleveland? </p>
<p>Have not seen any report that she contacted the CDC before leaving Dallas on Friday.</p>
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<p>No one told them they couldn’t travel. And it was before they made it public that the first nurse displayed symptoms. I don’t know if you can jump on the nurse. I don’t know if this isn’t again a case of bureaucrats scapegoating someone else for what they didn’t anticipate.</p>
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<p>No one is saying we would live happily ever after and suggeting it as a permanent solution. The ban will be a temporary measure until we have it under better control. Clearly it is working seeing other African nations that instituted travel ban are staying Ebola free. I get that if we leave the border open and people get sick here the problem will get more attention. What are we? Lab animals?</p>
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<p>How are we going to isolate the sick? I agree to that if you can isolate those infected Ebola and ban only them. One way to do that would be 21 day qurantine before allowing travel. I welcome that approach, too. Shall implement that? </p>
<p><a href=“http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/index.htm”>CDC: U.S. health worker with Ebola shouldn't have flown - CNN;
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<p><a href=“http://newday.blogs.cnn.com/2014/10/15/should-air-travel-be-restricted-because-of-ebola/”>http://newday.blogs.cnn.com/2014/10/15/should-air-travel-be-restricted-because-of-ebola/</a></p>
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Frugaldoctor, I have the greatest respect for your knowledge and experience, but you aren’t quite correct about this. In terms of individual patients, it may or may not be true, depending on the family situation within the US. As I said earlier (and I certainly don’t expect you to remember my posts), there is a strong, committed network of Liberians in the US, some of them are connected, smart and engaged. They can and do raise a lot of money to send back to Liberia for various reasons, most of them truly excellent. A lot of money. As I posted sevral years ago, my daughter worked for a couple of years in a school with a huge Liberian population and was very involved with the families and support network. While it may be true on the average that most Liberians are poor and can’t access the funds to travel, it is not true across the board on the individual level and may be less true in real numbers than many people looking from the outside in may think.</p>
<p>Travel bans may not catch everyone, but catching as many infected people as possible and preventing entry is how we can stop the transmission. That’s what the whole concept of quarantine is about on both the macro and micro level.</p>
<p>And it is beyond silly to the point of insulting that our government insists that commercial planes are the best way to get equipment, supplies and medical personnel to hot zones. Of course the emperor has clothes. No, he’s not really naked!</p>
<p>How many Ebola cases are there in Liberia? About 10,000? Liberia population is about 4 million. So that compares 1 or 2 cases in Dallas among 7 million residents vs. 10,000 among 4 million Liberians. hmmmm…. Shall we close up Dallas and leave borders wide open for Liberians? </p>
<p>Let’s assume maybe another 10,000 Liberians are infected but not showing symptoms yet. If the 150 daily African travelers are all from Liberia chances are that 3 in 10 are infected and asymptomatic. In 10 days we are letting in 3 infected people to the country. Are traveling Liberians are wealthier and less likely to be affected as frugaldoctor says? Let’s say so and pick a number. If they are 50 % less likely, then we let 3 infected people in 20 days. Either way, it sounds a lot to me.</p>
<p>“No one told them they couldn’t travel.”</p>
<p>I know that. </p>
<p>I was just asking if she had called the CDC before she left Dallas. </p>
<p>“One way to do that would be 21 day qurantine before allowing travel. I welcome that approach, too. Shall implement that?”</p>
<p>Are you including residents in Texas being quarantined for 21 days before being allowed to travel outside of Texas? </p>
<p>Dallas County may declare a state of emergency today
<a href=“http://www.dallasnews.com/news/metro/20141015-dallas-officials-plan-new-limits-on-health-staffers-in-ebola-case.ece”>http://www.dallasnews.com/news/metro/20141015-dallas-officials-plan-new-limits-on-health-staffers-in-ebola-case.ece</a></p>
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<p>What are the consequences that are so great? The only thing I hear over and over again is inconveniencing aid workers. Unless they want to make people here sick to keep awareness up but can’t come out and say so.</p>
<p>WHO predicts 10,000 new cases per week by December in Africa, and CDC predicts 1.4 million cases in Liberia and Sierra Leone by end of January . Sounds pretty contagious to me. </p>
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<p>Why not follow the procedures the US military thinks wise for its personnel? </p>
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<p><a href=“http://www.cnn.com/2014/10/15/us/ebola-us-troops/index.html”>U.S. troops in Ebola mission may be quarantined - CNN;
<p>At least, the military thinks highly enough of military families to not even risk exposure and will quarantine personnel of 21 days, even in asymptomatic. And they are doing it not even knowing if the personnel were near patients or not. </p>
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<p>Just the chance that they might be near an infected person is enough for the military to institute this 21-day quarantine policy and the right to quarantine entire units for 10 days. </p>
<p>This is seems a lot more thoughtful than what other agencies are thinking of the US public at large.</p>
<p>Another case of what is good enough for thee is not good enough for me. One arm of the government saying one thing to the public, while it institutes a more cautious, protective policy for itself.</p>
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<p>Emily, You love to talk about isolating Texas. Let me repeat my numbers. There are 26 million people in Texas. 2 people sick and about 100 being monitored. There are 10,000 people sick in Liberia and probaly another 10,000 infected. there are 4 million people in Liberia. Help me with arithematic here. 100 infected (not) out of 26 million, that is 0.00004 vs 10,000 out of 4 million 0.0025. 0.004% vs 0.25% I don’t know about you but I can live with 0.004% risk.</p>
<p>The measures the Saudis are taking to protect the Haj are very interesting. No pilgrims have been approved from Sierra Leone, Liberia and Guinea, as well as other serious measures.</p>
<p>I’d welcome 21 day qurantine of travelers.</p>