Ebola: Can we trust people to self-quarantine?

Not long ago, I read a blog post that predicted trouble brewing with Ebola, because humans simply will not take precautions. We barge out into the world as if we’re invincible, and we don’t worry about those around us who might NOT be invincible. This latest Ebola case, where the New York doctor tested positive for Ebola, is perfect proof of the folly of that belief.

Here is a doctor, a member of the medical profession, who we’re supposed to trust in all medical decisions, looking risk in the face (ours) and shrugging it off. The government didn’t force him into mandatory quarantine after coming out of an Ebola-ravaged country where he treated Ebola patients. They trusted him to be careful on his own.

He wasn’t.

After treating active Ebola cases in Africa, he flew into New York on a Friday. He did not self-quarantine for three weeks to prevent spreading the Ebola virus, in case he’d been infected. Nor did he self-quarantine for two weeks. He must not have self-quarantined at all because he started feeling ill the following Tuesday, and by Thursday was sick enough to call for help, and then he tested positive for the virus.

In the meantime, between Friday and the following Thursday, he went jogging, took a taxicab, ate at a meatball shop, visited a coffee stand, went bowling, and traveled on three different subway lines. That’s a LOT of activity in just a few days, and it doesn’t count the three people that he specifically spent time with: two friends and a fiancée.

Of course, he “wasn’t contagious” during any of that time, because he “wasn’t symptomatic.” In a blog post entitled, The Ebola News Cover-Up, I touched on the fallout of what happens if you don’t self-quarantine and then test positive, and the havoc it wreaks on every business that you walked into, with business shut-downs, loss of income, and even planes being taken out of service and their crews sent home for three weeks.

I was stunned at the choices the doctor made in potentially exposing hundreds of people to the Ebola virus. Personally, I would NOT want to eat in a restaurant that someone ate in who is at high risk for carrying Ebola, and still within the 21-day quarantine period. Nor would I want to use the bowling alley, or ride the subway, or whatever. It really makes you want to hole up and not come out, period, as long as nobody is forcing a quarantine. He knew that other doctors and nurses had fallen ill after coming back home, so there was a definite, clear risk.

I’ve chosen to remain silent through most of this, but wow. This just galls me.

Wasn’t it just a week or so ago that a nurse chose to fly on an airplane full of people, knowing that a fellow nurse had just been diagnosed with Ebola from a patient that they were both treating?

Then there’s the cameraman who caught Ebola while covering the story in Liberia. If it’s so hard to catch, and he wasn’t a medical professional touching and treating patients, then how did he become infected? At least the entire news crew flew back to the U.S. on a private, chartered plane, and then quarantined themselves for the requisite 21 days.

We’re hearing about a handful of new Ebola cases, urging us not to worry, that it really isn’t very contagious unless body fluid is involved, and they are being wishy-washy on this whole body fluid issue. Such as, if an infected person sneezes, and you’re in the field of spray, as you’d be on a subway, are you at risk?

Some of the infected were wearing protective suits, covered up from head to toe, complete with face masks, gloves, and presumably even their shoes wrapped up like an astronaut, and yet they caught Ebola, and we’re being urged not to worry about the risk, because the risk is so low that casual contact doesn’t spread the virus.

Here’s the thing. The CDC website says that yes, you CAN catch Ebola if an infected person sneezes on you, but that coughing and sneezing are not common symptoms, and the droplets must come in contact with your eyes, nose, or mouth. So, if your eyes are open, and someone near you sneezes and doesn’t cover their mouth fully, and those droplets fly, you could catch it.

That brings up the next question: how far does a sneeze travel? Well first, it travels about 100 miles an hour, faster than your hand could fly up to cover your face against someone else’s sneeze. I repeat: A sneeze travels one hundred miles an hour.

Fact number two: A single sneeze can send 100,000 germs into the air.

Fact number three: It was previously thought that sneeze droplets traveled no more than one or two meters, which rounds out to a maximum of 6.5 feet. Now they are saying that a sneeze can travel “up to 200 times farther than previously thought.” So let’s see, 6.5 feet times 200 equals — a distance that will not protect you in a room, restaurant, subway, or anywhere else if active droplets hit you in a vulnerable area.

Not only that, the smallest droplets can stay airborne long enough to get sucked up into a ceiling vent. This is the stuff they were talking about BEFORE Ebola landed on U.S. soil, when a sneeze just hit you with a nasty case of the flu.

Now, of course, it’s Ebola, a deadly contagion that tortures you until you die so that you bleed out of your eyes and ears and other places, so we’re not supposed to worry. Vulnerable areas only mean your eyes, nose, mouth, an open cut or wound, or an abrasion. I can think of a lot of ways to have an open cut: a paper cut, razor cut, or cat scratch being common ones.

Okay, so how long does the Ebola virus live on surfaces such as door knobs, cart handles, and bathroom handles? Just because Ebola may not make you sneeze, what if you have allergies on top of it? Some people sneeze all day long with allergies, and sometimes hefty gobs fly out of your throat in addition to sneeze droplets. So that little fun-fest at the bowling alley, or ride on the subway, if he was contagious, and happened to sneeze, and nobody was there for it to land on, what would happen to the germs?

The germs would land on a surface, and live there for several hours. I repeat: An Ebola germ can live on a surface for several hours. But oh wait, if it happens to be in a body fluid on that surface, and the fluid stays fluid, the Ebola germ can survive for several days at room temperature. So that gob of snot… how long does it take to dry up? Has anyone even measured that?

If you don’t believe me, go look it up on the CDC and WHO websites. And while you’re at it, look at their estimations for the next three months, such as the Morbidity and Mortality Weekly Report posted on September 26, 2014, before we started hearing about Ebola on U.S. soil.

  • December 6, 2013 — Patient Zero, one small child in Guinea, who died
  • March 22, 2014 — 49 cases in Guinea (CDC)
  • August 31, 2014 — 3,686 probable, confirmed, and suspected cases in West Africa had been reported (CDC)
  • September 23, 2014 — 6,574 actual cases reported in Africa
  • Confirmed: Cases were doubling every 15-20 days in Liberia, and every 30-40 days in Sierra Leone (CDC)
  • October 20, 2014 — With aggressive precautions, Nigeria and Senegal were declared Ebola-free, but Guinea, Liberia, and Sierra Leone were still reporting cases, along with The Democratic Republic of the Congo (CDC)
  • October 22, 2014 — 139 new cases per day in Guinea, Liberia, and Sierra Leone combined (WHO)
  • January 20, 2015 — Estimate given: If 70% of the patients are effectively isolated, and other precautions are taken, we’ll be reporting less than 300 new cases per day (as opposed to a worst-case 1.5 million total) (CDC)

So we’re at 139 new cases per day right now, in Africa. If we isolate as many patients as we know about, and take every possible precaution, we’ll only have 300 new cases per day, in Africa. Somehow, these two numbers don’t add up to a result that gives comfort.

Am I being an alarmist? Yes. After a doctor chose not to self-quarantine and went into several public venues when he should have stayed home, that causes alarm, especially with the holidays coming up. Nobody is going to stay home during the holidays, even if they feel sick.

It gets worse, too. If you catch it, and survive, and recover, you can’t spread the virus. But… the Ebola virus has been found in semen for up to three months. So, does that mean AFTER you’ve been declared free and clear? Or only if you are still contagious? Read the wording on the CDC website. It does not answer that question, but it seems to imply three months, period.

And humans aren’t the only carriers. Fruit bats, monkeys, and apes can also spread it. And guess what other animals have also tested positive for the virus? Antelopes, rodents, and even dogs, although they may not actually become ill. Officials are currently testing and quarantining the pets of the infected, just to be safe, and one dog was even euthanized in Spain. So we are quarantining pets who are not proven to spread the disease, but not people, who are?

Researchers are not certain whether a dog can spread the virus, but a March 2005 article entitled, “Ebola Virus Antibody Prevalence in Dogs and Human Risk,” by Lois Allela, Olivier Bourry, Regis Pouillot, Andre Delicat, Philippe Yaba, Brice Kumulungui, Pierre Rouquet, Jean-Paul Gonzalez, and Eric M. Leroy, studied the issue.

Dogs become infected, but they do not become symptomatic. Of the human cases that were studied in Africa, some of the human cases could not be traced to a source of exposure. They had no physical contact with an infected person, nor with an infected carcass. That means they caught it some other way, possibly through “droplets and aerosols,” or even unidentified animal sources. It has not been proven that a dog can infect a human, only that a dog can test positive for Ebola.

The unknowns “raise important human health issues” according to the study. Dogs are always licking body fluids of humans, including blood and saliva. Researchers concluded that “canine Ebola infection must be considered as a potential risk factor for human infection and virus spread” and that it was “possible” for a human to become infected through “licking, biting, or grooming.” That is why dogs are an official aspect of containing Ebola outbreaks, and it explains why the dog of one patient was quarantined, and another euthanized.

What frightens me more than Ebola itself is what happens if the virus takes root in the U.S. The authorities will be so focused on humans, that our beloved canines could end up euthanized out of an “abundance of caution.” Veterinarians have already laid out the rules regarding quarantines and the handling of your dog should you test positive for Ebola. It’s not a small affair, and it involves contact tracing just as with humans, such as visits to dog parks, animal clinics, daily walks, and groomers.

Then there is the issue of catching your dog to take him to quarantine. They have to wear a full, protective suit when taking your dog out of the home, and put up a temporary fence to ensure that he doesn’t get loose during the process. An Animal Control officer is supposed to be present, in case the dog proves “difficult” to capture. They don’t spell out how this would go down, but I’m guessing the result would be a dead dog.

The transport vehicle must be fully disinfected after dropping the dog off at the quarantine facility. In quarantine, the dog must be kept away from all other animals, and unauthorized people, under two-level containment. If your dog makes it this far, his caretaker must gear up in full, protective gear when caring for the dog, and even when scooping his poop. This includes double gloves, a disposable hooded suit with foot covers, eye goggles or a face shield. This is the short version, and it’s enough to convince me that the authorities would deem it easier to simply euthanize Ebola-exposed dogs, should an outbreak of Ebola occur on U.S. soil.

So why aren’t we quarantining high risk people?

The dog risk has not been proven, only suggested, but all of these facts combined, with sneezing and dogs and the life span of an Ebola germ, especially in semen, should give one pause to wonder why we are so anti-quarantine, trusting people to quarantine themselves like the doctor who went bowling, rode the subway, took a taxi, visited a coffee shop, and ate at a meatball shop.

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