Were you as surprised as I to hear of that RN in Spain? On national media, it was as if only the US and West Africa existed, without a thought given to how the disease could spread elsewhere. I will have to think about that later. At least, in Europe, they have Universal health care.

There was no breach in protocol and there was no reason for this nurse in Spain to get this disease, Ebola, and yet, she did.  The airports could have taken the Liberian’s temperature until the cows came home and it would not have stopped his entry into this country.  He was not yet contagious.  The nurse in Dallas should have passed on to the doctor’s that the patient was at high risk for Ebola, but I have to ask.  Since Ebola was on the minds and lips of just about everyone in West Africa, why on earth did the patient not mention it to the doctor?  It doesn’t matter.

What matters to me is the apparent confusion and lack of information.  I am 72 and I forget things.  I seem to remember that the incubation period for Ebola was 21 days.  Now I heard that it is eight to ten days.  That is kind of important.  I am also concerned that the Liberian’s family continued to live in the apartment for days after the patient was diagnosed.  That raised, for me, a very red flag.  I know that we are told that contact with bodily fluids can transmit the disease.  My concern, as with other viruses, is whether fomites are an issue in the transmission of the disease.  [It is interesting that the word “fomites” sets off a spell check error in MS Word]  It appears that I am not the only one who has not been able to determine as to whether Ebola can be spread by fomites.

Despite the fact that Ebola has been around for years, this lack of information is scary and probably keys into the fact that only 230 of the 3,000 soldiers that Obama promised to send to West Africa.  We are in the process of building ONE of the 17 promised hospitals.  We do not intend to staff them, but rather train West Africans.  The hospitals will hold 100 patients, but the patient load in West Africa is doubling every two to three weeks.  Unlike here in the US, In West Africa, patients are being kept in the hospitals 6.4 days.  While our intentions are noble, they are entirely inadequate.

“A month ago, in its so-called Ebola Response Roadmap, WHO wrote that the number of cases ‘could exceed 20,000 over the course of this emergency.’ In the new model, it projects that number to be reached by 2 November, if the epidemic continues to grow unchecked.

There is more bad news. Although WHO has earlier said that roughly half of the Ebola patients die, the paper estimates that the case fatality rate is actually just above 70%. ‘I think that that can be brought down through more aggressive therapy to well below 50%,’ Aavitsland says. Offering a better shot at survival is important to convince patients to seek care instead of staying home, he says, where they may infect others. ‘At the moment, all these treatment units have to offer is a lonely death.’”

So what does all this mean to us?  Through their infinite wisdom, twenty-three GOP controlled states have NOT expanded Medicaid.  That means that millions of poor, middleclass Americans are without health insurance and will not go to a hospital or doctor until they get really sick.  You do the math.  Our Public Health System and hospitals could easily be over run by ignorance, fear, and yes, Ebola.

I hate it when I hear our national media scream every night about Ebola, like some cheap tabloid at the grocery check-out stand.  I dislike it even more when I actually sit down and assess this looming crisis in our midst. I hate it even more when I realize that I live in one of those twenty-three states.  On the other hand, this might return control of Congress to the Democrats.

http://www.nihbrp.com/Citations/completed/HumanHealthEcologyTeam/IssueBrief/Bausch_Ebola_Trans_1968.pd

http://blogs.dallasobserver.com/unfairpark/2014/10/cdc_dallas_ebola.php

http://news.sciencemag.org/africa/2014/09/who-cdc-publish-grim-new-ebola-projections

http://www.advisory.com/daily-briefing/resources/primers/medicaidmap