How Many U.S. Cities Need An Ebola Case Before Preventative Measures Are Taken?

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Should we be worried about Ebola? That’s the question on the minds of many Americans given the first documented case on U.S. soil this week. And now there is a second possible case, someone having contact with Thomas Duncan, the first U.S. case of Ebola.

Thomas Frieden, director of the Centers for Disease Control and Prevention reassures us, “I have no doubt that we’ll stop this in its tracks in the U.S.” President Obama also told us two weeks ago that “the chances of an Ebola outbreak here in the United States are extremely low.”

Tell that to the 100 Texans who had contact with Thomas Duncan and are now being monitored or held in isolation. Or to the panicked parents keeping their children home from school. Or to those living near Mr. Duncan. After showing disease symptoms, Mr. Duncan, “Was seen vomiting on the ground outside an apartment complex.” According to the CDC, “Under ideal conditions Ebola virus could remain active for up to six days.”

What’s more ideal than the streets and sewers of warm and humid Dallas, where the vomit was likely flushed?

As I wrote two months ago, the CDC has a history of downplaying risk, whether from anthrax or HIV/AIDS. So it’s no surprise that the natural inclination of Americans is to mistrust the promises of another agency. Don’t forget that there was, “not smidgen of corruption at the IRS” and that “if you like your doctor, you can keep your doctor.” The government and its mouthpieces frequently say what they think we the people want to hear, not what we need to hear.

Now I am not recommending panic, but how about some common sense precautions? Perhaps travel restrictions from endemic areas? Air France and British Airways have suspended flights to West Africa. Many African nations reacted to the Ebola outbreak, “by canceling flights and closing borders.” Unlike these countries acting proactively to protect its citizens, the White House is taking the opposite approach saying, “It will not impose travel restrictions or introduce new airport screenings to prevent additional cases of Ebola from entering the United States.”

Mr. Duncan presented himself to a Dallas hospital with low-grade fever and abdominal pain. Normally this would be called “the stomach flu” and the patient sent on his way with recommended fluids and rest. But Mr. Duncan told the hospital he traveled from Liberia. The alarm bells that should have been ringing were on silent mode and none of the hospital workers thought anything of his travel history. An easy mistake to make in a hospital that probably never thought it would see an Ebola patient. And Texas Health Presbyterian Hospital Dallas is not a mud hut hospital staffed with a shaman and a few witch doctors, it has earned top patient safety marks from the Leapfrog Group. Meaning that this could happen at virtually any US hospital. All the more reason to stem the disease at its source via travel restrictions.

If we are not restricting travel from the hot zones in Western Africa, how about a quarantine? Once upon a time, when America was still just a collection of colonies, health officials in New York Harbor set up quarantines for immigrants, “To prevent the bringing in and spreading of infectious distempers.” Is it practical to quarantine a plane load of passengers? It is certainly more practical than panicking an entire city such as Dallas over the hundred or more people that may have come in contact with someone infected with an untreatable and fatal infection.

Then there is the southern border. A viral illness, Enterovirus D68, causing muscle weakening and paralysis in children is spreading across the country, at a time when our southern border is wide open. No travel restriction and no quarantine for those crossing into America from parts unknown, bringing infections unknown. Ebola is not all we have to worry about.

Despite being proven wrong time and time again, the government tells us, “Don’t worry, be happy.” How many cities need an Ebola infection before preventative measures are put into place? And by then will it be too late? Good question. As was one recently asked by President Obama: “So the question now is whether we will have the courage to act before it’s too late.”

Too bad he was talking about global warming and not Ebola.

Brian C. Joondeph, MD, MPS, is a Denver-based physician.