I am very much of Helen Branswell’s mind that the world’s effort on Ebola, including that of the United States, should be focused on West Africa. That’s the fire; the U.S. patient is a spark. To stop sparks, snuff the fire.
In the meantime, however, the U.S. response to the appearance in Dallas of what is essentially our Patient Zero is, to put it charitably, not encouraging.
First, this yesterday from Delay in Dallas Ebola Cleanup as Workers Balk at Task, by Kevin Sack and Manny Fernandez at the NY Times. NB: There are four people living in that apartment, ordered to stay there so as not to spread infection. This is also after the hospital failed to admit the patient and sent him back to the apartment when he first went in.
More than a week after a Liberian man fell ill with Ebola and four days after he was placed in isolation at a hospital in Dallas, the apartment where he was staying with four other people had not been cleaned and the sheets and dirty towels he used while sick remained in the home, health officials acknowledged on Thursday afternoon.
And from the Guardian, US Ebola patient’s friends quarantined under armed guard:
At midday on Thursday, a child peeked out from behind a red diamond-pattered curtain in one of the apartments while at ground level a team of three contractors – none wearing any sort of protective clothing – power-washed the front porch. A stroller stood at the bottom of a staircase.
Earlier, a representative of one of the agencies who issued the control order said that arranging clean bedding was the responsibility of the family – despite the ban on them leaving their home. “The individuals, it’s up to them … to care for the household,” Erikka Neroes of Dallas County health and human services told the Guardian. “… Dallas County has not been involved in a disinfection process.”
So the richest country on earth has no team to contain the first appearance of one of the most deadly viruses we’ve ever known. Instead, apparently untrained contractors without protective clothing show up four days late and use not bleach and buckets to kill and contain the presumed hazard, but a power sprayer to blast them around.* The family this patient was staying with, meanwhile, is left to its own devices, isolated from the world. They’re left to deal with the sheets and towels themselves. The fate of these linens, uninspected but possibly the most infectious single item associated with Patient Zero, is left to chance.
This response is what you get when a country essentially has no sense of what public health is about. It’s a crystallized expression of an abiding feature of our so-called healthcare system: Health is something you do in a hospital or a doctor’s office. Generally you must pay to get it. Reach one of those places and maybe we can help you — an event more likely if you show ability to pay, and pay big. (Would the hospital have so quickly sent home a patient who had insurance? Statistically less likely.) Outside the paywalled environs of hospitals and offices, though, you’re on your own.
This is no way to treat fellow human beings. This is no way to stop an epidemic.
*At least one reader feared I was spreading panic here, and noted that any virus on the porch, depending on what it was in (surface v liquid, etc.), might (or might not) have died by the time the power-spraing occurred. Apparently there was TV and web coverage last night that made much of the power-washing and speculated heavily on how it might spread things.
I see my critic’s point about the danger of spreading panic (and the fuzzyness of whether the spray-washing was a real hazard). I still suspect that no matter what the hazard at that point, power-washing is unlikely to be best practice, since it spreads stuff rather than gathers it. But I want to make it clear I pointed this out not because I consider the practice in this case a huge threat and that we should freak out because OMG We’re All Gonna Die, but because power-washing by unprotected contractors 4 days late is another indicator of a weak, uncoordinated, and tardy response at an important site.