<p>The OFFICIAL link provided in Scout’s post does NOT say that WHO recommends 42 day individual quarantine. The 42 days without any new cases in a given country is what WHO will use to declare the end of the epidemic in said country!</p>
<p>"How does WHO declare the end of an Ebola outbreak?</p>
<p>A WHO subcommittee on surveillance, epidemiology, and laboratory testing is responsible for establishing the date of the end of an Ebola outbreak.</p>
<p>The date is fixed according to rigorous epidemiological criteria that include the date when the last case with a high-risk exposure completes 21 days of close medical monitoring and tests negative for the virus.</p>
<p>According to WHO recommendations, health care workers who have attended patients or cleaned their rooms should be considered as “close contacts” and monitored for 21 days after the last exposure, even if their contact with a patient occurred when they were fully protected by wearing personal protective equipment.</p>
<p>For health care workers, the date of the “last infectious contact” is the day when the last patient in a health facility tests negative using a real-time reverse-transcriptase polymerase chain reaction (RT-PCR) test.</p>
<p>For WHO to declare an Ebola outbreak over, a country must pass through 42 days, with active surveillance demonstrably in place, supported by good diagnostic capacity, and with no new cases detected. Active surveillance is essential to detect chains of transmission that might otherwise remain hidden."</p>
<p>I was thinking more about the practicalities of setting up quarantine facilities for people who have traveled in the primary affected areas arriving in the US. It would appear that if the goal is to protect the US, such a facility would have to be set up at every international airport in the country. It isn’t feasible to try to force all international flights to arrive at only two or three airports.</p>
<p>Assuming for the sake of argument that the actual quarantine period was 21 days, with perhaps some level of monitoring for the following 21 days, people arriving each day would have to be sequestered so that they were not potentially exposed by people arriving later. This means they would need at least 21 “suites” that could be rotated through as the inhabitants “aged out.” And any person who appeared to become symptomatic would have to be immediately isolated, so that if they <em>were</em> infected, they did not affect their suitemates. Would having a suitemate become symptomatic automatically restart the quarantine clock? </p>
<p>Potentially, people could end up in quarantine almost indefinitely. This doesn’t even begin to address the issue of whether people on a plane with a passenger who became symptomatic during the flight should also be quarantined. Everyone? Just people sitting next to them? How about people who used the same bathroom? Where does it stop?</p>
<p>If WHO says it is fine, it is fine. Why not 100 days? Why not use a 6 sigma approach? </p>
<p>Because you have to draw the line somewhere for cost/benefit sake. A person who is facing 42 day quarantine is less likely to even report to the authorities. </p>
<p>You’re right, BB - I couldn’t find any “official” statement from WHO about changing the quarantine recommendation. IN fact, if you go to the WHO link you posted, they’re still citing the 21-day rule.</p>
<p>I always heard that the “95%” rule was the standard - not the 98% conditions. I wonder if the recommendation from WHO has really changed. I wonder if the ‘change’ to 42 days (…if it really is a change…) is more of a PR move. After all, there is no quarantine length that gives you 100% certainty. Why don’t we just quarantine people indefinitely? (/sarcasm)</p>
<p>BTW, I believe I read that Vinson already bought her dress at that store. So <em>hopefully</em> she wasn’t trying on dresses, her bridesmaids were.</p>
<p>Although I think it was irresponsible of her to travel by public transport–and I think she knew it on some level, otherwise she wouldn’t have called the CDC–I feel for her. She just wanted to plan her wedding and get on with life. (Like Eric Duncan.) It’s very sad. I hope she makes it.</p>
<p>Scout, I do not think it is even a PR move. It is some dumbhead reporter who found the document on WHO guidelines for diagnostic testing used for the declaration of the end of the epidemic and interpreted it in his own way. This is irresponsible reporting. This is FUD in its purest form!!</p>
<p>I would like to see the official statement from WHO. Not a report in the Examiner.</p>
<p>Yes, it would be best to look directly at WHO statements, as it is tough trusting journalists when they are out to get ratings and “scoops,” rather than be so concerned about accuracy.</p>
<p>^^ Agreed., BB. I can’t believe we’re really supposed to extend the quarantine for 3 more weeks just to reach 98% confidence, unless there’s further data of which we are not aware That doesn’t sound like WHO science at all - actually, it doesn’t sound like ANY kind of science. </p>
<p>Given the fact that you probably do not hire PR people or have them advising you free, I understand your post. </p>
<p>If you set up a fund asking the people for money, three things come with that: 1) you become obligated to keep the public who gave you money informed, 2) it gives the funders the assurance that their money was well-spent and serves as receipt of sorts, and 3) it serves, as a visual stimuli to convince others to give, thereby increasing the fund.</p>
<p>Some PR person smartly told her family the above. Expect more pics and onto about her, as this goes on. an if she continues to improve.</p>
<p>That will change of course if she gets worse actually because agencies also have their PR people they will not want the visual of a dying person because of their errors. </p>
<p>But, given any improvement, her pics serve both her and the agency trying to fix its image of not doing things well initially. And part of not doing things well is the agency never put a verification process in place re what protocols were being used. Thus it never did its job securing that she was properly trained, which is that agency’s job, IF it issued those directives. The agency should have had two checks: verification checks of the hospital and follow-on verification checks that the individuals were correctly trained buy the hospital. That is what a private company would do, and they did neither,.</p>
<p>Bottom line - these pics serve both her and the agency in a positive way.</p>
<p>Why is it not science? The study is just saying it takes 21 days for 95% and 42 days for 98%. That is science. It will be up to epidemiologists to decide what they call good, 95% or 98% since nothing is 100% in real life. I wouldn’t know what the standard is.</p>
<p>But, I doubt a small business of that sort would even think of that type of insurance, as that insurance is usually for catastrophic events that affect business property, such as fire, flood, broken pipes, etc, which covers the edifice, inventory and patrons’ clothes. A random person coming into your store sick is nothing like that. But, if it is lucky it might have an escape clause, but that would be unique.</p>
<p>However, the major problem is who will trust any of the gowns from them for a while. Such small businesses live at the margins, even when they do well and often do not have the reserves to ride out complete evaporation of part of their business. And the business most likely also lost all its future useful, sustainable growth for the foreseeable future and any major already signed contracts in its pipeline. It will take a hit, as will the businesses next to it. </p>
<p>Took me a while to figure out the agency is CDC. I agree. That would have been the only way you know you are prepared. But they failed in something far more elementary if what they say about the issued protocol is true.</p>
<p>You getting into what the military explained today on Capital Hill. </p>
<p>You are piggybacking on the CDC language which scientifically is not a very dependable scale for knowing when someone is truly infectious simply because what looks sickly to one person may not look sickly to another person.</p>
<p>The General explained that different doctors have told them differing things. Even the very top disease expects disagree about the specifics of the disease infectious state and transmission. The jury is still out there. Given that obvious disagreement, the military realized it could not with confidence know which personnel might be infectious or not based on the CDC current criteria, and it decided not to take the chance and instituted the 21-day quarantine.</p>
<p>And this is what I mean about the an accountable responsibility chain, which the CDC does not have. If the military sends a disease back to a base, it could completely reduce readiness of particular weapons group. That is serious responsibility to try to avoid that, as the military actually produces something of necessity, i.e., defense. Additionally, if the military sends a person back and that person infects his family, the military has to pay for their healthcare and even their long-term care, if there is any of that. The CDC has none of this responsibility and would not have to pay for damages. The military would have to pay up in one form or another, with a hit on readiness possibly endangering its prime directive. </p>
<p>Yes, her uncle made this perfectly clear on CNN tonight; in fact, he requested to extend the interview so that he could correct this misinformation that anyone who knew her had set it up. It is bogus.</p>