<p>Yes, he came home 10 days ago. Fever 103.</p>
<p>Connecticut placed a family of six from West Africa, with no symptoms, in quarantine for 21 days.<a href=“http://www.reuters.com/article/2014/10/23/us-health-ebola-usa-idUSKCN0IC1VN20141023”>http://www.reuters.com/article/2014/10/23/us-health-ebola-usa-idUSKCN0IC1VN20141023</a> Apparently, like Dallas considered but did not proceed with, Connecticut has declared a state of emergency, which gives it authority to order people into quarantine. </p>
<p>How did they know there was a family from West Africa in the state?</p>
<p>That is a very good question. Perhaps they arrived into JFK recently and were permitted to do home quarantine in CT. </p>
<p>This is a prime example of how a policy that is supposed to help with stopping the spread of the disease turned out to be not so helpful. The president of Liberia issues cremation decree, and hospital beds clear out since the ill are afraid that they would be cremated if they go to the hospital:</p>
<p><a href=“http://news.yahoo.com/cremation-fears-leave-empty-ebola-beds-liberia-193925994.html”>http://news.yahoo.com/cremation-fears-leave-empty-ebola-beds-liberia-193925994.html</a></p>
<p>(I recall that initially the CDC page on burials of Ebola victims in the US said “cremation,” but now it includes burial in certified hermetically sealed caskets - to accommodate religious beliefs).</p>
<p>At least this potential case happened in a city where people are likely not to become hysterical with fear. </p>
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<p>There are always unintended consequences of any policy. The end result is what one looks at: the policy - unintended consequences. Obviously, she underestimated the cultural response to cremation, which looks like it is leading to the negative result you properly highlight. </p>
<p>We also saw the same thing here. There are many in this country who never saw the unintended consequences of trusting someone to truthfully fill out a health form would lead to: a premier american hospital essentially becoming medical and financial junk (leading to less medical services for the Dallas community); the cafeteria vendor for Dallas Preb saying they will need to layoff people; the medical complex next door losing 50% of its patients; a wedding dress store possibly needing to close; and over $25M in cancelled conferences for Dallas. </p>
<p>If the CDC knew its open travel policy would, without testing and screening, in total, affect an american community to the tune of $100M+ just for one imported case of Ebola, then they would not have implemented such an open travel policy, not to mention the trust lost in the CDC by the general public and many doctors. </p>
<p>“the unintended consequences of trusting someone to truthfully fill out a health form”</p>
<p>Do you have some proof that Duncan lied on his health form? </p>
<p>Experts wonder why some people recover more quickly than others:</p>
<p><a href=“Why Has Nurse Amber Vinson Recovered From Ebola So Quickly?”>http://www.nbcnews.com/storyline/ebola-virus-outbreak/why-has-nurse-amber-vinson-recovered-ebola-so-quickly-n232431</a></p>
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<p>Bold is mine. </p>
<p>“If the CDC knew its open travel policy would, without testing and screening, in total, affect an american community to the tune of $100M+ just for one imported case of Ebola, then they would not have implemented such an open travel policy, not to mention the trust lost in the CDC by the general public and many doctors.”</p>
<p>So… What happened in Liberia was highly predictable. </p>
<p>In the quote above, you cite CDC’s “policies”. Travel restrictions are outside of the CDC jurisdiction. The CDC is the agent for carrying out the policies per Department of Health orders, which has the powers to authorize such actions as travel restrictions and monitoring of arriving pax:</p>
<p>"Under section 361 of the Public Health Service Act (42 U.S. Code § 264), the U.S. Secretary of Health and Human Services is authorized to take measures to prevent the entry and spread of communicable diseases from foreign countries into the United States and between states.</p>
<p>The authority for carrying out these functions on a daily basis has been delegated to the Centers for Disease Control and Prevention (CDC)."</p>
<p>“The Secretary of the Department of Health and Human Services has statutory responsibility for preventing the introduction, transmission, and spread of communicable diseases in the United States. Under its delegated authority, the Division of Global Migration and Quarantine works to fulfill this responsibility through a variety of activities…”</p>
<p><a href=“Specific Laws and Regulations Governing the Control of Communicable Diseases | Quarantine | CDC”>http://www.cdc.gov/quarantine/specificlawsregulations.html</a></p>
<p>I’m confused, Bunsen. You say the CDC is not responsible, the dept of Health is. But then your quote says they have delegated responsibilities to prevent entry and spread of the disease to the CDC. So it looks like your quote contradicts you. Or is it like most govt agencies? Nobody wants to take responsibility.</p>
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<p>The CDC and State Department have instituted an in-country tracking program of some sort. Not sure of the full details. But, travelers from hot zone countries can no longer enter the U.S. and just travel where they want, like Duncan did. They must state where they are going; provide address for which they will be staying; must be available at all times to be monitored; and are limited to where they can go for some number of days. That is what I understand the program to be. There might be other details, as well.</p>
<p>There are also new forms and restrictions for private jet travelers.</p>
<p>Given the above, not too hard for CT to know that they were in the state, as I would suspect part of the monitoring is state supervised.</p>
<p>As for the issue of the CT state of emergency, that is federalism at work. The economic counsels of many states have studied the impact on Dallas and the Texas economy, and many cannot risk a potential downgrade.</p>
<p>Everything makes sense. Only when the Secretary of Health/ Surgeon General order so, the CDC can move in and monitor pax, detain them and test them. Without the higher powers, it can’t do all of that - that would be unconstitutional. Here is the pertinent statute:</p>
<p><a href=“U.S.C. Title 42 - THE PUBLIC HEALTH AND WELFARE”>http://www.gpo.gov/fdsys/pkg/USCODE-2011-title42/html/USCODE-2011-title42-chap6A-subchapII-partG.htm</a></p>
<p>AW says it is the CDC’s authority to shut the borders. The 42 U.S.C. does not agree. :)</p>
<p>@#1971 That’s an improvement.</p>
<p>The NY doctor who is being observed was in self-imposed quarantine. It makes life simpler in case he is decided to have contracted ebola. </p>
<p>If that is true (the doc was in self-quarantine), then NYC can breathe a bit easier. It was a volunteer MSF doc, so s/he probably was taking every precaution in this self quarantine. </p>
<p>It’s he, 33 yr old man. I don’t think self-qurantine is required of returning health care workers. It will be interesting to know what fraction of them exercise self-qurantine.</p>
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<p>I heard on the news that the NY Doc self quarantined as well. It looks like he was smart about things. He knew that he was possibly exposed, he acted responsible, and the City had a plan in place to manage a situation like his. Lucky for NY they were the second to have to deal with this. It makes it a lot easier to do it the right way when you watched the situation in Texas. </p>
<p>I think we had to actually see Ebola on our soil before we got serious about putting a plan of action together. It was unfortunate for Texas that they had to be the Guinea pigs. So far we have been pretty lucky that things didn’t get worse considering how poorly things were handled. I am glad that people, hospitals and cities are more aware now. </p>
<p>According to other news reports, the doctor did NOT self-quarantine. From CNN:</p>
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<p>I’m guessing he DID self-quarantine after he showed symptoms. I’m not insinuating he did anything wrong at all - just saying that he was out and about on Wednesday before he started feeling sick today:</p>
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<p>Sure hope he’s okay!</p>
<p>In case you need to quarantine a pet… Here is Bentley’s story:</p>
<p><a href=“http://www.wfaa.com/story/news/health/2014/10/23/bentley-ebola-quarantine-virus-experiment-grand-prairie/17792393/”>http://www.wfaa.com/story/news/health/2014/10/23/bentley-ebola-quarantine-virus-experiment-grand-prairie/17792393/</a></p>
<p>(My buddy lived through a small-scale (although not so dramatic) nightmare when the cat needed radioactive iodine treatment. The cat did not like to be isolated, and the other cat did not like to be alone. They both howled day and night. Yikes.)</p>
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<p>It’s interesting that Amber Vinson was excoriated in the press for traveling on Friday October 10 when she allegedly began “feeling funny,”(very low grade fever did not show up until right before her return flight to Dallas on Monday October 13) and now people on that first flight are supposedly being tracked and monitored. This doctor allegedly “began feeling sluggish” a couple of days ago and he went out and about town on Wednesday night just hours before feeling fairly ill and people are congratulating him for “self quarantining.” </p>
<p><a href=“Ebola-positive doctor Craig Spencer now quarantined in one of four special infectious disease rooms at Bellevue Hospital – New York Daily News”>http://www.nydailynews.com/new-york/doctor-treated-ebola-patients-rushed-bellevue-fever-article-1.1984941</a></p>
<p>I have no idea if these reports are true, but if they are, I don’t see how this is radically different from the Amber Vincent flight #1.</p>
<p>Obviously, if any of the details I reference are in error, please correct.</p>