Lessons from the Case in Dallas

It’s still early days in the case of the man who hopped off a plane in Dallas two weeks ago carrying Ebola, was checked into a local hospital a week later with symptoms, to be discharged after, presumably, being told (in the nicest possible way) not to be such a whinger. I’ve read reports that Mr. Duncan is not doing well. It’s not to early to draw a few lessons from the incidents.

First, voluntary quarantines or limitations on travel don’t work. I’ve read multiple reports that Mr. Duncan fortified himself with ibuprofen to reduce his fever before getting on the plane. People lie. They’ll do what they need to do when their lives are on the line.

Second, the protocols presently in place in the United States for healthcare workers to identify and isolate Ebola are inadequate and will never be adequate because they’re implemented by human beings. This is no six sigma affair.

There are more lessons ahead. For example, if Mr. Duncan dies it will be because Ebola is a deadly disease rather than because he’s being treated in a Third World country. And if Ebola becomes endemic in West Africa, as may well occur, or, worse, if it travels to Brazil or Indonesia and becomes endemic there as well there will be future lessons.

18 comments… add one
  • I’m tired of these lessons. These are why people drop out of school, ’cause learning sucks.

  • steve

    I hope they continue to investigate the first hospital that saw him. Cant believe they sent him away.


  • mike shupp

    Look on the bright side. Maybe Ebola’s going to strike us all down and devastate the nation , but at least the odds that we’ll each have healthcare through insurance have improved in recent years.

  • jan

    I agree with Steve. The hospital sending this guy home seemed to be clueless and incompetent, all at the same time.

    However, this first Ebola test case should open some eyes as to how similar hospital judgement errors could inadvertently help spread this virus, along with national fear that seems to be only growing.

    Tight, disciplined medical guidelines disbursed and universally followed in this country will be the way Ebola is successfully contained and managed. So far, though, I’m not satisfied that this is happening yet.

  • CStanley

    I don’t know how the ER doctor and other medical personnel are sleeping at night knowing that they screwed up so badly. Had they tested and quarantined this man in the first visit, the risk of spread wouldn’t have been zero but it would have been so much lower than it is. Even if the ER doctor wasn’t told that the man had recently arrived from Liberia….wasn’t it obvious that he was looking at an African national, exhibiting suspicious symptoms?

    Also inexplicable, if true: I read reports that the patient himself probably knew he had come in contact with Ebola. I can somewhat understand rationalizing to himself the risks he out others in by traveling to the US (not really excusable but understandable.) What would be unconscionable, though, would be doing that and then exposing everyone in his family rather than coming to the US and self-quarantining. I find it so hard to believe that a person would expose loved ones, including children, that I lean toward the assumption that the reports were false- but there were several people interviewed who claimed to know that he was exposed and knew it.

  • CStanley, those doctors & nurses have probably made lots of catastrophic mistakes before, though this one had greater potential scope for adverse effects.

    Also, the hospital personnel couldn’t have spotted he was an African national. There’s no such thing as race or ethnicity. For all they knew he was Icelandic, Japanese or Patagonian. For that matter, men & women are the same, so they couldn’t know he wasn’t a she. That’s SCIENCE.

    Finally, how educated do you think Duncan is about how Ebola spreads? Does he know about germ theory & such? Maybe he thought the cause was evil spirits or mercury in vaccines.

  • jan

    What would be unconscionable, though, would be doing that and then exposing everyone in his family rather than coming to the US and self-quarantining.

    Supposedly the man took advil before his flight out to disguise any symptoms of fever. He knew he was sick, but probably just wanted out of there and rationalized what he was doing.

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