I see that Dr. Thomas Frieden, director of the Centers for Disease Control is walking back his cocksure remarks of Sunday:
DALLAS — As a 26-year-old Dallas nurse lay infected in the same hospital where she treated a dying Ebola patient last week, government officials on Monday said the first transmission of the disease in the United States had revealed systemic failures in preparation that must “substantially†change in coming days.
“We have to rethink the way we address Ebola infection control, because even a single infection is unacceptable,†Thomas Frieden, director of the Centers for Disease Control and Prevention, said in a news conference.
Frieden did not detail precisely how the extensive, government-issued safety protocols in place at many facilities might need to change or in what ways hospitals need to ramp up training for front-line doctors or nurses.
At least that’s hewing closer to the known facts. I continue to wonder how he plans to implement a protocol that’s 100% effective, especially considering that we already have at least 100,000 deaths per year in the United States as a consequence of infections picked up in hospitals. The reports of casual violations of ordinary sanitation precautions in hospitals are legion.
The World Health Organization’s definition of a disease outbreak is “the occurrence of cases of disease in excess of what would normally be expected in a defined community, geographical area or season.” Despite what I suspect will be strenuous efforts to deny it single case in Dallas constitutes an outbreak of Ebola here in the United States and I strongly suspect that investigation will determine that it was preventable by something less than heroic measures.
As every twelve step program emphasizes the first step on the way to recovery is recognizing you have a problem.
When I read the assertions that the protocol is effective, I think of the Yogi Berra quote you used in the previous quote. The point is, the flaws of the current protocol are most likely in the implementation of it, not in the theory behind it.
But that’s why things like checklists and spotters are useful in situations where you need the protocol to be as close to fail-proof as possible. I read this morning that this is exactly what is in place at the Nebraska Medical Center, as it should be.
And there goes just a little more credibility for the CDC, just because they’ve made a point of expressing metaphysical certitude about matters which do not allow such. That is, theyve made a point of being arrogant pricks, a condition endemic to both medical doctors & bureaucrats.
And one less than heroic measure that would have prevented this outbreak would have been to deny entry to people from the afflicted countries.
I’m almost curious enough about how Reynolds is spinning this as another brilliant success of the great Obama to check OTB. Almost, but not quite….
Dr. Frieden is a near-perfect example of my gripe about technocracy. Under a true technocracy he wouldn’t be allowed to head the CDC or get near a microphone for that matter because he’s not qualified for either of those roles. The CDC would be headed by somebody with formal administrator’s credentials, spokespeople would have credentials for making public statements, etc.
In our faux technocracy graduating from med school means you must know everything about everything.
The problem is, of course, that technocracy is absurd on its face. Requiring special training and certification for everything is just impractical. IMO it’s just a stalking horse for hereditary aristocracy.
Dr. Frieden is a near-perfect example of my gripe about technocracy.
Isn’t that one of the primary traits of social progressives — to place all confidence in “degree” experience and relatively little in hands-on experience? Just look at the backgrounds of those in the inner circle of the WH. They are mostly college-bred, hyper-partisan political hacks who have had relatively little real life exposure or skills, especially in the much-maligned business world! So much of their facts and truths are based primarily on computer modeling, manufactured talking points skirting the truth, theoretical speculation, and intra-group validation with little dissent recommended let alone heard. Much like Penetta’s conclusion, though, to what’s going wrong in the WH, it’s become a reactive governance in DC, not one that incorporates decisive leadership, because of too much thinking, not enough doing, resulting in a paralysis of long-lasting, working solutions.
Relevant to the Ebola scare, we are seeing the same pattern going on that we have witnessed all along with this administration, whether it’s the non-stimulating stimulus, the unprepared HC roll-out, the failure to act in a timely manner in order to prevent a gathering force from becoming a crisis, and now a CDC director who first seemed unflappable, now having lots of question marks applied to the words he used to mollify the public.
One thing after another has happened to put more cracks in the confidence of those who are supposedly the brightest and best minds leading this country.
We are going to disagree a lot here. First, Frieden has a Masters in Public Health as well as a fellowship in infectious disease. That is kind of like having an MBA in the health care world. He has extensive managerial experience in several health care settings. What kind of background would you prefer? Seriously, you are quick to criticize this guy, what would you rather have instead? Here you have a guy who is capable of understanding the medical issues he oversees, not just a pure admin type who doesn’t have a clue about the product, and real management experience. I don’t know the guy. He may or may not be competent, but his background is very good.
Next, people make mistakes. We have protocols that we know will absolutely protect you from getting AIDS. Among those is, don’t stick yourself with a needle. Yet, people still stick themselves occasionally. Less than in the past as we have learned to improve the protocols and the equipment. So, maybe the protocols can be improved. I suspect the gear can be made better. Everyone in the trade knows that. I have to confess that I am not even sure what your real complaint is in this vein.
Outbreak? Did you really expect zero cases here? I hope you realize that is impossible. We have done a remarkable job of minimizing its spread here, but it was inevitable.
Last, what did he say that was cocksure? I read that twice.
Steve
Cocksure is stating, as he did the other day, that the protocols are 100% fool proof and that this MUST be human error, without actually knowing that to be the case. Today?
“We have to rethink the way we address Ebola infection control….”
He didn’t have to be so goddamned sure of himself the other day.
Outbreak? Did you really expect zero cases here?
From the President’s speech on September 16th:
First and foremost, I want the American people to know that our experts, here at the CDC and across our government, agree that the chances of an Ebola outbreak here in the United States are extremely low.
They were TELLING us that the chances were “extremely low”, not that it was inevitable and they would strive to contain it when it happened.
This is what I mean when I state they’re destroying their credibility by making blanket assertions.
Despite what I suspect will be strenuous efforts to deny it single case in Dallas constitutes an outbreak of Ebola here in the United States and I strongly suspect that investigation will determine that it was preventable by something less than heroic measures.
Ebola happens all the time in the United States of America. But just like spontaneous combustion, it doesn’t get reported much, because it just isn’t “news”.
“Next, people make mistakes.”
Steve, that’s the crux of the problem too — being aware that people make mistakes which then disproves that “100 %” reassuring remark made by the director. It’s a fine line that such an expert spokesman for the CDC has to walk. He has to be calm, not employing hyperbole to hype the problem — factual presentations help to accomplish this. But, he also can’t dismiss the seriousness this virus poses due to our lack of experience with it, the unknown mutation risks it might have, containment issues due to the inevitable breakdown of protocol in hospitals, airports etc. which then leads to a false sense of security and public complacency — something just as dangerous as generating undo fear.
Immediately claiming the nurse fucked up without knowing what happened waa obscene on Friedman’s part, particularly when almost no one in American hospitals has been trained to deal with this situation nor given the proper equipment. For those reasons his claim that any hospital in the country was capable of effectively managing ebola victims was kooky; the CDC should be designating one hospital in each state for treating victims and moving mountains to train and equip their staffs properly, but as yet this doesn’t seem to be happening.
Even as the CDC has hastened to reassure the public that the virus won’t spread in the U.S., the agency doesn’t monitor hospitals and has no authority to make sure they comply with official guidelines, according to Abbigail Tumpey, a CDC spokeswoman who is leading the education outreach to hospitals.
“There are 5,000 hospitals in the U.S. and I would say probably the number of them that have actually done drills or put plans in place is small,†she said.
It’s up to each hospital to enforce infection control, and standards vary depending on funding for infection experts and time devoted to training.
“We have been screaming for the past three months that hospitals are not prepared,†said Deborah Burger, co-president of National Nurses United, which represents 185,000 nurses across the country.
http://mobile.bloomberg.com/news/2014-10-12/ebola-control-training-lags-with-gap-in-federal-oversight.html
“From the President’s speech on September 16th:
First and foremost, I want the American people to know that our experts, here at the CDC and across our government, agree that the chances of an Ebola outbreak here in the United States are extremely low.”
Absolutely. He remains correct. A single case that came here from Africa is not really an outbreak. Dave is flat out wrong on this. We also know that health care workers who take care of these patients are at risk. Even the people treating these folks in Africa sometimes get sick. We will likely get sporadic cases showing up for years. It is very unlikely that these individual cases will turn into an outbreak with dozens of cases stemming from an initial case or cases as has been the case in Africa.
Query- Anyone have the quote where Frieden claimed 100% effective? I can’t find it after searching for an hour. If he actually said that he is flat out wrong.
Steve
I meant to write Frieden earlier, not Friedman. Guess I’m use to heaping my contempt on the Times stooge.
But the nurse’s contracting it is. At least according to the WHO.
“what would normally be expected in a defined community”
Part of the defined community for Ebola is health care workers. Those who take care of them sometimes get the disease. While we are new to this it is even more likely that some workers will contract the disease. This is still not an outbreak.
Just out of curiosity, since you are widely read, I assume you know about the problems with resistant TB that our public health system has been dealing with for quite a while now. We have had a number of deaths from it. (The US averages about 500 TB deaths per year.) We know it is endemic in Africa and Asia, especially Afghanistan. Why don’t we have the same kind of fuss? People are really dying, but no calls to cut off flights. No criticisms of the CDC. Where is the panic?
http://www.cdc.gov/tb/topic/drtb/default.htm
Steve
I think there are two reasons. First, La Boheme notwithstanding, Ebola is a lot more dramatic than TB. Second, the death rate per 100,000 diagnosed cases is far higher with Ebola than with TB.
Please recall I’m not panicking. I don’t even think that we should ban flights from West Africa. At least not yet. I can think of a half dozen things I’d recommend doing before that.
But I do think we should take the travel issue more seriously than it has been taken to date.
Next you’ll be asking what the meaning of is, is.
And I’ve heard people in real life complaining about drug-resistant TB and plain old whooping cough making their way across the border, as well as the recent outbreak of enterovirus-68. (Not going to go into, but I don’t currently believe the enterovirus outbreak is due to the now open border.)
Given all the crazy conspiracy theorists, I can’t believe you haven’t heard it either.
And the defined community for ebola includes all medical personnel, whether in Monrovia, Patagonia, Dallas or Reykjavik. Got it. Maybe Kim Jong Un caught it from his personal physician.
For that matter, given that damned near everyone in the first world sees people in the medical community, I guess we’re all the the defined community. That’s comforting, now that it’s cleared up.
And now it looks like there were no protocols in the hospital in Texas. Those statements made by the President last month and by Frieden over the weekend aren’t holding up to scrutiny.
@jan
What you have are people who claim to be scientific, but they hate the scientific method. I have gone over this, and I am tired of repeating myself.
They are a cargo cult. They have no idea of how things work. They see people push buttons and pull levers, and they believe that the pushing buttons and pulling levers is what makes things work. They do not understand that the buttons and levers need to be connected to something, and they need to be connected to the correct thing.
The Surgeon General President Obama nominated was more concerned with a political issue than any medical issues. For the cargo cult, gun violence is causes medical trauma, and there is a lot of gun violence. Gun violence is an epidemic, and therefore, it is a medical issue.
Ebola, ISIS, the economy, terrorists, Putin, China, etc. are all approached from a politically correct, flower power, comfortable sofa in a safe living room mindset. What is becoming painfully obvious is that none of these respond to the usual tactics.
Conferences, marches, protests, name calling have no effect on any of these. Not only is that is all they know how to do, but they have spent years negating the solutions that could work. If the Ebola outbreak was in Europe, a travel ban would not be immediately ruled out. When a terrorist act is potentially a right wing group, there is no hesitation in the rush to judgement.
This is what I mean when about being the boss. President Obama did not understand that being president is more than sitting behind the desk in the Oval Office.
The big difference between conservatives and the left is that many conservatives can be brought to see reason. I have rarely ever found the left willingly admit defeat or even doubt, and I have been doing this for about thirty years.
On many issues, you are willing to concede that the other side may have some valid points, but how often do they do the same? If I had more patience. I could probably get you to at least consider different aspects of issues, but I am more of a fighter. Actually, I am a really nasty fighter. Believe it or not, I really do hold back.
They will not concede defeat, but reality is intruding upon the fantasy they have built. At this point, I do not even engage over their beautiful world. I have time, and they do not.
“Ebola, ISIS, the economy, terrorists, Putin, China, etc. are all approached from a politically correct, flower power, comfortable sofa in a safe living room mindset. What is becoming painfully obvious is that none of these respond to the usual tactics.”
I can’t argue with that, Tasty. There appears to be no hands on, or on the ground experience background in any of these superiors in office anymore. They check the boxes of education, contacts, and correct ideological profiles and they get the job.