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Doctor in New York City Is Sick with Ebola
- jeffdavis 12y agoI'm not afraid of Ebola as much as the "experts" who keep intentionally misleading us about Ebola. I don't know why they do it, and that scares me. But it's very obvious that it's intentional. See the first three sources I found about Ebola transmission in sweat: http://well.blogs.nytimes.com/2014/10/03/ebola-ask-well-spread-public-transit/?_php=true&_type=blogs&_r=0 http://well.blogs.nytimes.com/2014/10/03/ebola-ask-well-spre... (claims that sweat doesn't contain Ebola) http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/epr-highlights/3648-frequently-asked-questions-on-ebola-hemorrhagic-fever.html http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemi... (claims that Ebola can be transmitted through sweat) http://www.cdc.gov/vhf/ebola/transmission/qas.html http://www.cdc.gov/vhf/ebola/transmission/qas.html (hard to tell whether they think sweat is a transmission mechanism or not... they define "body fluids" twice, once including sweat and another excluding it) I also heard on NPR that sweat contained a lot of the virus (don't have a reference handy). Real experts don't shoot their mouth off with false assurances about a disease we don't know much about. The "hard to catch Ebola" mantra was going on long after that was discredited[1]. These aren't experts, they have some kind of agenda, and I'm not sure what it is. For some, it's probably just being on TV. For others, it's to feel smug about how the ignorant masses under them are panicking irrationally. As for the rest, probably political. Again, I'm not panicking about Ebola. We'll have a few isolated cases in the West. It will remain in Africa in all of the hot zone countries until we have a vaccine. And hopefully that happens before it spreads to Nigeria, India, Brazil, or other areas where it might be hard to control. I am not panicking. I am just mad at the irresponsibility of these "experts" we keep hearing from. [1] No references here, but I think everyone remembers that the first story was that, unless you were engaging in some unsanitary funeral practices deep in an African village, it was impossible to catch. After doctors began to catch it, the story changed to be that they don't have enough resources to protect themselves. Then several Western doctors got infected while in hospitals in Western countries (Spain and the US at least), and the story changed into something about how the protocols will protect us, but were just not followed properly these few times (despite not knowing the specific protocol violations that lead to infection).
- msie 12y agoThe doctor should have known better than to go to a bowling alley soon after he returned. Whether or not he was contagious now they have to perform contact tracing and disinfect the place.
- jbarrec 12y agoTotally agree. It sounds like he was all over the place, and using mass transportation. If anyone needs to seek refuge out on Long Island just let me know!! :D
- natch 12y agoNot to mention riding the subway. Good luck doing contact tracing with that. I'm not saying he was contagious. I hope he wasn't. Was the bowling alley public subway trip really a must-do thing, for someone who had just directly worked with ebola patients? Could this kind of thinking not be part of the training for this kind of work, I wonder?
- maxerickson 12y agoI think discipline is the bigger issue than awareness. Even someone who absolutely knows better can end up thinking that the bad thing can't happen to them.
- georgemcbay 12y agoYup. In my experience with experts I'd say especially someone who "knows better" can end up thinking that the bad thing can't happen to them right up until they, in a fit of being human, have an oops and it does.
- bjz_ 12y agoYeah. I hate this 'holier than thou' attitude that some folks on this thread are displaying. We are all human, and we all do stupid things based on our psychology. The best we can do is create systems to help guard against our own mistakes.
- imaginenore 12y agoWow, this moron went bowling and took a taxi. Unbelievable.
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- 001sky 12y ago"People infected with Ebola cannot spread the disease until they begin to display symptoms, and it cannot be spread through the air. As people become sicker, the viral load in the body builds, and they become more and more contagious." This is sort of misleading in this context, unfortunately. The WHO considers (sustained presence) within 1 meter of EBV carrier to be ~physical exposure. The young doctor appears to have been on a NYC subway within 12 hours of having a fever of 103. Creating a potential group of exposures that may be un-traceable. Maybe someone can correct me if I'm wrong. But this would be highly unfortunate if these reports are correct. Presumably the uber driver is also in this group now, but records should be able to provide some data on that one much easier.
- wfjackson 12y agoMany signs point to the viral load not being highly infectious at the beginning. Duncan was sent back to his home by the hospital and lived with his fiance who was taking care of him for two days before being readmitted. She wore no PPE yet appears to be uninfected. If sitting next to someone infected on a bus or subway is enough to pass it on, there would be a million cases in West Africa by now, not 10K. It appears to be primarily caregivers at the later stages of the disease, and the custom of kissing corpses that appear to be spreading the disease because the viral load is extreme at that stage. This doesn't mean that the potential contacts of this person should not be traced or that it was good idea for him to go bowling, but the sky isn't falling just yet.
- kamaal 12y agoEbola can spread only after a person begins to show symptoms. And that takes ~21 days. Or putting it straight, for it to spread from one person to another it would take 21 days of period in between getting infected and spreading it to others. Though the growth of number of patients with Ebola is definitely exponential. Please note it takes 21 days for the each multiplication to happen. It started in March and has been been spreading since, 10K is pretty large for a 7 month period. >>but the sky isn't falling just yet. In things like this you won't know when the sky will start falling apart. And generally when that happens its already too late, and you would be staring at a pretty big damage. No body knows how many people have been infected, or will be infected in the next multiplication. Which is why WHO suspects ~1.4 million could get infected by January. By then it would be too late.
- googler_314 12y agoBefore judging this man for going bowling etc., we should bear in mind that he caught Ebola working for Doctors without Borders in Guinea. I would guess that without workers like him, the risk to Americans and others outside Africa, would be much higher, since the disease would be spreading much faster within Africa. Hopefully he recovers and we can improve travel policies if necessary.
- bjz_ 12y agoAgreed. He might have been silly for being out in public right after having come back from Africa, but I'm sure he did more good over there in preventing the spread of the disease (which helps us), than he might have done when coming home. Lets hope future doctors learn from this.
- jeffdavis 12y ago"I'm sure he did more good over there in preventing the spread of the disease" Why are you sure?
- blisterpeanuts 12y agoCold comfort if he has created a public health crisis in the city. He should have self-quarantined upon his return, in my opinion.
- rustyconover 12y agoTo borrow an idea from math, "doing good" isn't a commutative, infections and diseases are. Have some respect for others and slow your roll before going out during the 21 day post exposure window. It's a bit like saying, "Hey I've saved lives over here so I have earned the right to be irresponsible over here". Because you know, karma balances out. No, the world doesn't work like that. And you aren't doing any good propagating this idea either because it encourages this privileged way of thinking. As much as this guy isn't being vilified (and say what you want about the government spinning its story of ebola being hard to transmit), lets think clearly and rationally. He knew the risks that he could possibly be infected and decided to endanger others when he could have easily stayed home or gone anywhere to a more isolated environment (upstate NY is calling). It is well known symptoms generally show up by the 10th day. Today is his day 10. It's very interesting that the government has locked down this guys apartment, yet if you need contact with bodily fluids to contract the disease why quarantine the apartment and surroundings? Could it be that droplets are a transmission method as many people are starting to suspect. Sneezing and coughing may spread these droplets to the floors and walls? And if that is the case, what about other objects that come in contact with saliva and other fluids like utensils, door handles, glasses...
- akjetma 12y agoDo location-based services work in the NYC subway? I suppose you could also infer locations and transfers based on train schedules and tower handoff times upon emerging from stations. I mean, if there is a 21-day gestation period between infection time and the ability to retransmit the disease, it seems like it would be worthwhile/possible to look into. Apologies for the cliche 'use technology to solve all the problems' HN comment.
- uptown 12y agoNot the underground tunnels. Some of the stations have service, but not most.
- malandrew 12y agoBut you should be able to infer location from the gaps. If someone was at station A, then disappears and 2 minutes later is recorded at station be, it should be possible to know they took the train between those two stations.
- uptown 12y agoYup. There's ample data from metrocards and security cameras to follow his route. The more difficult challenge would be finding everyone he had come in contact with on those trains since data granularity of which cars he took would likely be unspecific.
- malandrew 12y agoIt would be interesting to allow people in New York to compare their phone location data with his to determine the likelihood that they had contact with this person. It should be standard practice to give someone returning from West Africa that had contact with ebola a GPS tracking device the records their exact location for 21 days following the last know exposure. This notion that anyone exposed to ebola is basically responsible for keeping tabs on their own well being voluntarily leaves way too much room for human error.
- joe_the_user 12y ago"Many signs point to the viral load not being highly infectious at the beginning. Duncan was sent back to his home by the hospital and lived with his fiance who was taking care of him for two days before being readmitted. She wore no PPE yet appears to be uninfected. If sitting next to someone infected on a bus or subway is enough to pass it on, there would be a million cases in West Africa by now, not 10K. It appears to be primarily caregivers at the later stages of the disease, and the custom of kissing corpses that appear to be spreading the disease because the viral load is extreme at that stage. This doesn't mean that the potential contacts of this person should not be traced or that it was good idea for him to go bowling, but the sky isn't falling just yet." wfjackson https://news.ycombinator.com/item?id=8501792 https://news.ycombinator.com/item?id=8501792 Please look at this first
- jeffdavis 12y agoPeople move through the stages at different rates with a high variance. That's still pretty scary.
- uptown 12y agoHe was a passenger in an Uber. It doesn't sound like they've made any effort to ensure the vehicle was cleaned. http://blog.uber.com/nyc-statement http://blog.uber.com/nyc-statement
- uptown 12y agoNYCs Ebola Patient Visited: -Harlem -An Uber car -The High Line -A restaurant -A Train -Jogged 3 miles -L Train -1 Train -The Gutter
- westward 12y agoBased on the timeline, he had to have contracted Ebola pretty much the day he left. That seems pretty unusual, isn't it? How long was he there, a couple months? "Symptoms usually occur within eight to 10 days of infection and Dr. Spencer had been home nine days when he reported feeling ill." That's not including travel time local and international. That's a tight schedule!
- malandrew 12y agoAt the same time, I wouldn't be surprised if people tend to let their guard down in the days and hours before they leave the country. Instead of quarantining by default, I think it would be interesting to offer a free, relaxing vacation in a low population density region to people who are returning from helping in Africa. i.e. you cannot leave West Africa and return to a major city directly. Instead you fly back to your home country by way of a desirable destination and hang out there for a few weeks.
- capkutay 12y agoGiven gov't budgets in disease prevention, they're more likely to quarantine people in prions than a relaxing vacation
- hga 12y agoIt would be really cheap for the rest of us to provide "the basics", e.g. a flatscreen TV (get the cableco or DirectTV and/or Dish to donate service), Internet connection (ditto on trying to get it for free from a provider) and if needed a computer, and then it won't be that onerous. Historically to my knowledge we typically haven't gone the prison route outside of special cases like Typhoid Mary.
- jberryman 12y agoI think this is something like selection bias: had he contracted ebola earlier he wouldn't have returned to the US, or maybe would have been shipped back for treatment, which would be a very different headline.
- knappador 12y agoHow about "Doctor Returning From Guinea..." to more accurately reflect the geographic relationship instead of creating a bomb of a headline as if some random, yet-unknown vector resulted in Ebola in New York.
- Houshalter 12y agoWhy does it matter who he was? The title is pretty accurate.
- knappador 12y agoWhere they just returned from makes the news highly generic, unsurprising, and it drops off the main page rapidly instead of being an attention grabber. Even the article that is linked to says "Doctor..." which at least leads me to believe that the just returned from treating someone. This is not incredibly surprising news, but if someone who just happened to be in New York with no obvious connection to the Ebola outbreak in West Africa caught Ebola, that would be pretty obviously significant since there might be someone who was unidentified and contagious in New York recently, suggesting that an outbreak could flare up in New York. News that misleads wastes time and makes money, but not my money.
- ASneakyFox 12y agoOf course it's being spread from a region with an ev outbreak. That's how it works. The news is that it has now officially spread to the US and there is potential of more cases popping up soon since he wasn't quarintined.
- shirro 12y agoThe smart thing would be for aid agencies that send workers to these hot spots to pay for their employees to stay in a nice quite "resort" somewhere for a month on their return for them to relax and as a thankyou for their efforts. And to deflect growing negative public opinion about the risks returning aid workers pose. Needless to say the "resort" could have daily health checks and minimal contact between people but could otherwise be quite pleasant.
- santaclaus 12y agoThat strategy certainly worked for the Venetians. Merchant ships had to chill off shore for 40 days before unloading their cargo to make sure no one harbored deadly diseases. Hence the quarter in quarantine.
- hackuser 12y agoThis response is poor risk management. I'm not sure the risk is significant: What is the chance that someone else will get infected? Higher than the many other risks we face every day? What is higher risk?: 1) Going to the Ebola zone in W. Africa (EDIT: And taking the proper precautions to protect yourself), 2) Walking as a pedestrian on NY streets, or 3) Sharing a subway car with someone who has been in the Ebola zone? There are around 3 cases of Ebola in the United States. I expect most of the resultant suffering will be because the public reaction is causing us to divert resources from where they could do more good (including West Africa).