Thomas Eric Duncan, the first person ever diagnosed with Ebola in the United States, died Wednesday morning, according to the hospital in Dallas that had been treating him.
Duncan’s death came eight days after his diagnosis, which set off a panicked search for anyone who may have had contact with him and sparked new fears over how ready hospitals and government agencies are for any additional Ebola cases in the country. He died at 7:51 a.m., Texas Health Presbyterian Hospital said.
Ebola is a deadly disease, killing half or more of those who contract it. Attributing recoveries to palliative care received in U. S. hospitals or experimental therapies administered is premature to say the least. Many will die; some will recover.
What must be noted from Mr. Duncan’s experience and that of the Spanish nurse who contracted Ebola is that doctors and nurses make mistakes. They make mistakes even when lives are in the balance. Even when their own lives and those of their loved ones are in the balance. Any protocol that depends on perfect compliance is doomed to failure whether it’s applied in the United States or in Liberia.
If we wish to mitigate the risk of an Ebola outbreak beyond West Africa, relying on protocols that require perfect adherence is a forlorn hope.
Has the method of transmission to the Spanish nurse been reasonably well established? I admit that faulty adherence to isolation protocols is most likely the cause of transmission, but it may not be her fault specifically.
Off the top of my head, in decreasing order of probability, the likely causes are faulty adherence to isolation protocols, faulty protocols based on current knowledge of the disease, faulty protocols due to incomplete/faulty knowledge of the disease, or changes to the disease itself.
Reading up on the disease in the last few days, it is clear that the researchers do not understand this disease or it’s transmissibility completely. A lot of the public health information pretends otherwise, but their level of certainty is substantially below 100%. Of particular concern is the 1989 (I believe) outbreak among the monkeys in Virginia, as the investigators seem fairly well convinced that the virus was transmitted via aerosolization. And some have frankly admitted they don’t know what would happen with ill subjects confined with healthy subjects in an enclosed environment over certain lengths of time, which has obvious implications for air travel in general and intercontinental flights in particular.
The Spanish public has nothing to fear. The government has everything under control. Spanish dogs, on the other hand, need to be afraid of coming anywhere near Ebola.
In the US, Jesse Jackson is going to fight Ebola with Civil Rights marches and demonstrations because it appears that Ebola is racist.
Allowing Ebola patients into the US and curing them has established that the US is the place where Ebola is cured. Anybody who has Ebola and who can get to the US will do anything they can to get here, and if they have any sense, they will bring their dogs as well.
You don’t need perfect compliance. You do need basic competence. In the US case, the pt told them he had been to Liberia and thought he had Ebola. He had a fever. This is not like trying to diagnose some obscure auto-immune disease. This was obvious.
Steve
It’s hard to get basic competence right, sometimes. When you have a virus that appears so deadly, is an unknown to this country, and has a big baggage of histrionics attached to it, people will react in very different ways — ranging from over the top to others being paralyzed in denial.
Hopefully, the U.S. will get a handle on the realities of Ebola, understanding more fully the perimeters of contagion and how to correctly dispose of contaminated waste, fluids and other items in order to prevent a preventable spread of the virus.
The Spanish nursing assistant is believed to have been infected while removing the protective gear, which is one of the hardest parts of the protocol to perform correctly. It is a weak link in the protocol, but that’s unavoidable unless we don’t treat patients at all.
The other errors that have been made have been blatant- the failure to test and quarantine the Liberian patient in Dallas on his first visit to the hospital, and the unnecessary delay and exposure of other patients when the Spaniard sought treatment (she was first told to stay home and take aspirin, then left sitting in a waiting room while symptomatic, potentially exposing other patients for 8 hours.) it remains to be seen how consequential those errors will be.
So, yes, while expecting perfection is fool hearty, expecting some basic level of competence and vigilance should not be too much to ask.
I find it depressing beyond measure that one day Jesse Jackson is on CNN talking about the patient and the next day the nephew has written a letter questioning why the “black patient” was the only one to die in the US.
I know it’s naive to believe that one day we’ll all be judged for our mistakes without regard to the color of our skins, but our (non)adherence to safe protocols.
Jesse, you weaseling sumbitch.
@Janis Gore
When disagreeing with a black president is racist, then a black man dying of a virus becomes racist, and marches and sit-ins become the cure.
On the other hand, one does not want to be accused of being a racist for suspecting a black man of having Ebola. It would be best to send him home. You can always be forgiven for starting an Ebola outbreak, but the racist label is unforgivable. Even if it were misapplied, the accusers will never admit it.
Ebola, ISIS, Mexican drug gangs, and excessive credit creation among others are a way of thinning the herd. They can be denied and pretended away until reality kicks you in the head, and you are bleeding from the eyeballs.