Fauci: Quarantine can have unintended consequences

[alp227]

Source: AP

WASHINGTON (AP) — Mandatory 21-day quarantines on health care workers returning from Ebola-ravaged West Africa, like those put in place by three states, can have the unintended consequence of discouraging them from volunteering, a top federal health official said Sunday.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that as a physician and scientist, he would have recommended against a quarantine.

"The best way to protect us is to stop the epidemic in Africa, and we need those health care workers so we do not want to put them in a position where it makes it very, very uncomfortable for them to even volunteer to go." he said.

He said active and direct monitoring can accomplish the same thing as a quarantine because people infected with Ebola do not become contagious until they start showing symptoms. Ebola is transmitted through direct contact with the bodily fluids of an infected person.

Read more: http://bigstory.ap.org/article/7db363a65faa4eff8a109140de5f7c06/fauci-quarantine-can-have-unintended-consequences

[TwilightGardener]

1. Ebola in Africa: fine.

Staying home for a couple or three weeks afterward: impossible!

The CDC wasn't worried about the Duncan family when they were quarantined. Only the important people should be allowed to roam. The CDC/NIH are inconsistent jokes when it comes to restricting THEIR rights (the rights of the elites who are better than the rest of us disease-ridden rabble, that is).

[Warpy]

2. Bullshit. The Duncan family stayed in their home

The way they're treating the nurse (who is negative so far) is WORSE THAN PRISON.

Do you get it yet?

Christie should be sued until he lives under a bridge for this one. There is no medical reason for this.

[customerserviceguy]

3. At least he'd close the bridge. n/t

[CAG]

16. +1000

[TwilightGardener]

27. Er, I said the word "home", did you miss that? I said repeatedly they should

come back and stay home (or place of their choice) for at least a couple weeks, if not three. I don't agree with the necessity of staying in a hospital, unless they have a symptom that needs to be resolved. The problem with the Duncan family is that they were literally locked in a contaminated apartment when they stayed at home, with little support at first. That's potential medical harm being done to them by the CDC or whoever enforced it. I have less sympathy for professionals who volunteer, KNOW what they're getting into, and have to be inconvenienced in some way because of it--way more sympathy for the Amber Vinsons and regular people who DID NOT sign up for ebola and encounter it anyway, and lose their vacation cruises, their belongings, their paychecks.

[magical thyme]

8. Christie saw fit to let Spencer's fiancee finish her quarantine in her home

after a day or two in the hospital.

Why are doctors and nurses not afforded the same consideration?

Why was this healthcare worker held and questioned for hours without even an explanation of why she was being held and without even decent food after traveling halfway around the world?

Dallas was caught totally off guard with Duncan, so flying by the seat of their pants. Christie has had a couple weeks to digest this and come up with a decent plan. There are MSF people everywhere. Hell, I live in rural Maine and a nurse not 1/2 mile down the street from me, who works in the same hospital I work in, volunteers with them on occasion. Did he not think NY might have potentially exposed people?

[Pathwalker]

11. Umm, is Christie now governor of New York , too?

I thought her apartment is in Harlem?

[magical thyme]

14. oops, my mistake. I forgot Spencer's in NYC, not NJ...nt

[TwilightGardener]

26. I think they SHOULD quarantine at home. I don't know why a separate facility

is necessary. Just send them home for at least a couple weeks and enforce it. Let their families bear whatever risks they want to assume. But the point is, if someone in close contact with contagious ebola victims needs to be quarantined, then ALL of them need to be quarantined, volunteer doctors and CDC staff too, not just the "little" people who are deemed unimportant, uneducated, or un-useful, like the Duncans or random lab techs or regular RN's and aides. There cannot be two standards for quarantine, one for VIP's that the government is hoping to attract and retain to work in Africa and one for the rest of us who apparently don't matter. Your doctor's or nurse's license shouldn't confer upon you some special right to freedom that the rest of us don't get in the same situation.

[kiri]

19. Ultra-violet light disinfects Ebola and other viruses

About Ultra-Violet to destroy Ebola outside the body:
http://www.americanultraviolet.com/whats-new.cfml
Ultraviolet Lights and the Sun both emit UVA, UVB, and UVC wavelengths. Ultraviolet lamps for disinfection utilize the proper amount of UVC wavelength exposure to disinfect. That's where it differs from sunlight exposure on the Earth. The Sun's rays have all three kinds of wavelengths, but only two of those UVA and UVB actually shine down to the Earth's surface. The UVC wavelengths are stopped by the Earth's ozone layer, and because of that, DNA based organisms including contaminants have not evolved to protecting themselves from UVC wavelengths.
When ultraviolet lighting is utilized for disinfection the light does all the work. UVC wavelengths penetrate the cell wall of the DNA based contaminant and alter the DNA of the contaminant. When this happens the contaminant is inactivated and unable to reproduce thus is essentially killed quite quickly. Based upon exposure intensity and lamp proximity most DNA based contaminants are killed in less then 20 seconds.
-------------------------
ARTZ/Pathogon Unit
Ultraviolet light has been deemed an effective way of helping to control the contamination of Ebola with surfaces after it is outside the host. The American Association of Blood Banks, Center for Disease Control, and various infection control journals have all provided some form of guidance on treating contaminated environments and have all recognized ultraviolet light as a valid and great tool for the job. Ultraviolet lamps are far more environmentally green than chemicals and there is virtually no issue of human error or not cleaning every surface. For example, the ARTZ/Pathogon unit can be rolled into an area, such as a patient's room after treatment, and can be turned on by a tablet and left in the room to clean. The air and all surfaces in the room will be disinfected in minutes while nurses or healthcare staff can spend time on other matters.
-------------------
http://www.ncbi.nlm.nih.gov/pubmed/21104283
Germicidal UV (also known as UVC) provides a means to decontaminate infected environments as well as a measure of viral sensitivity to sunlight. The present study determined UVC inactivation slopes (and derived D(37) values) of viruses dried onto nonporous (glass) surfaces. The data obtained indicate that the UV resistance of Lassa virus is higher than that of Ebola virus. The UV sensitivity of vaccinia virus (a surrogate for variola virus) appeared intermediate between that of the two virulent viruses studied. In addition, the three viruses dried on surfaces showed a relatively small but significant population of virions (from 3 to 10 % of virus in the inoculum) that appeared substantially more protected by their environment from the effect of UV than the majority of virions tested. The findings reported in this study should assist in estimating the threat posed by the persistence of virus in environments contaminated during epidemics or after an accidental or intentional release.

-----------------------
https://www.iuva.org/news/ultraviolet-germicidal-ir
UVGI devices are effective for health care settings and other public spaces where the danger of the virus spreading can mean the difference between life and death. Chlorine Dioxide has also been used to sterilize hospital rooms, fixtures, beds and equipment. UVGI used in healthcare settings to eliminate viruses such as Ebola have been found to be just as effective as Chlorine Dioxide with the use of UVC energy.
-------------
https://en.wikipedia.org/wiki/Ultraviolet_germicidal_irradiation
Ultraviolet germicidal irradiation
At a wavelength of 2,537 Angstroms (254 nm)[6] UV will break the molecular bonds within micro-organismal DNA, producing thymine dimers in their DNA thereby destroying them, rendering them harmless or prohibiting growth and reproduction. It is a process similar to the UV effect of longer wavelengths (UVB) on humans, such as sunburn or sun glare. Micro-organisms have less protection from UV and cannot survive prolonged exposure to it.

http://en.wikipedia.org/wiki/Ultraviolet
Ultraviolet C UVC 280 – 100 nm 4.43 – 12.4 eV

The absence of any mention about UV as a tool is upsetting. Surely this deserves a place between a real pandemic and continued panic and hysteria.

[customerserviceguy]

4. Now, healthcare workers are on notice

Doing this is not going to only take a week of your vacation. At least we could come up with something that would be at least as good as a Motel 6 in terms of the environment they'd stay in.

[Mr.Bill]

5. So lets say

a few hundred or even a few thousand cases of Ebola happen in the United States in the coming months. What percentage of our health care workers would be quarantined and unable to care for patients? There would eventually be a tipping point when virtually all our health care workers were quarantined. The focus should be on keeping them from being exposed to the virus while they care for patients, not locking them up and keeping them from caring for more patients.

[SheilaT]

6. And just how do you think a few hundred or even a few thousand cases of Ebola

could possibly happen here?

[Mr.Bill]

7. Don't know.

Just doing a little speculating about the slim chance that it would. The last sentence in my previous post was my main point.
Quarantining, in this case, I think is just a political stunt being used by politicians who want to make people think they are doing something.

[SheilaT]

10. Please explain how you think that thin chance can happen.

You do understand that it is not possible to get Ebola until the unfortunate with it has a large enough viral load as to be vomiting, having explosive diarrhea, and possibly bleeding freely from minor wounds? Yes? So how do you think we'll get hundreds or thousands of cases?

It's so unlikely to happen in this country as to be as close to zero as a number can be.

[Mr.Bill]

12. Like I said, I don't know.

Ask why our politicians seem to want to make everybody think so. That's what the problem is.


Now please don't ask me again how I think a major out break is going to happen. I don't know, and I never said I did. Got it?

[SheilaT]

13. But even going about saying what if

hundreds or thousands of cases occur isn't helpful.

[Mr.Bill]

18. Which is precisely why our politicians

shouldn't be trying to score points with the ignorant by acting the way they are.

[magical thyme]

9. Last week some DUer posted an article by a scientist or science group that said statistically we

could have 20 cases by the end of November.

The more it rages out of control, the higher the odds of more Duncan's showing up on our shores. By the end of December, who knows...

The world is waaaay behind the curve in trying to rein it in. By the time we have built facilities for 2500, there will be 5,000 new cases per week. WHO says 70% need to be isolated in order to stop the spread. Cuba is sending 3-400 doctors, which will replace those that have died, but will be treating (or not able to treat) far greater numbers.

[Chemisse]

21. It's very unlikely to happen.

But it doesn't hurt to plan ahead when one is making policy, particularly since Ebola is not the only pathogen that could create this situation.

It is untenable and counterproductive to quarantine the returning health care workers for several reasons, including the one mentioned above.

[JDPriestly]

17. According to a doctor I spoke to who has agreed to take the ebola training, the quarantine

is part of the job of caring for ebola patients. They will learn how to use the equipment and protect themselves and their patients. Ebola is extremely contagious when it is full-blown. But if caught early as we saw with the nurse who just recovered from it and as we have seen with others that have recovered, the disease can be controlled.

You are right that the focus should be on keeping them from being exposed. But the focus also has to be on preventing doctors who have been exposed (even with all the equipment to prevent infectious exposure) from becoming themselves contagious. That can be done. Even in West Africa, many medical volunteers work without contracting the disease.

Becoming a doctor is a rigorous process. The doctor that I know well was not only tested for her knowledge, extensive knowledge of science, but was interviewed before being accepted into medical school. The personality, the dedication, the work required to obtain a medical degree and then to go through residency and perhaps the training necessary to enter a specialty topped off by long hours on the job and then keeping records -- all mean that the person who becomes a doctor is dedicated to helping care for the sick.

It's not like working at any other job.

[JDPriestly]

15. A friend of mine who is a doctor volunteered to be trained for ebola responsibilities in her

hospital. She discussed it with me and said she felt it was her duty as a doctor to take upon herself the risks that are associated with caring for seriously ill, infectious patients.

Then she told me that she had been advised that after caring for an ebola patient. she would be quarantined for 21 days. She lives alone. One of the reasons that she volunteered is that she is single and has not family.

The thought of a quarantine did not frighten her. She was only worried about how she would buy food. I assured her that someone would help her.

I do not believe for a minute that the thought of a potential quarantine will discourage medical personnel from volunteering for ebola duty.


Yes. It would be difficult for those with families and children to stay in quarantine for 21 days. But the risk to their families of going home potentially carrying the risk of contamination to their children or others in the family with compromised immune systems would be greater than the quarantine.

Someone with medical training has to be willing to take upon themselves the risks and personal inconveniences of treating ebola patients. Let's hope that good doctors do this.

Selfish doctors will not volunteer. Dedicated doctors (and nurses) will. It is the task of government and society to make sure that the quarantine period is not too much of a burden, psychologically or financially on those who treat these patients.

The article is full of it. Doctors are trained and dedicated to care for the sick. It's part of their job, and they have to do it. The good ones know that.

[seabeyond]

20. your friend need not concern herself. since she is informed, she can fly in washington or mass.

and get home however she chooses, wherever she is.

this only effects those flying into NY and NJ.

[JDPriestly]

24. When she signed up for the training she understood that she would be quarantined 21 days

after treating a patient. I don't know whose rule that is. Could have been the rule of her hospital.

[SheilaT]

25. Quarantine for 21 days after caring for an Ebola patient

is beyond stupid. It means that those imposing the quarantine do not understand things like incubation period. They are idiots.

[Chemisse]

22. Selfish doctors will not volunteer?

What if a doctor just has two weeks a year to volunteer? But the quarantine turns that into a 5-week stint? That doctor is just not going to be able to give up the time; there is nothing selfish about that.

[JDPriestly]

23. The doctor should be compensated. But doctor that I wrote about works in a hospital already.

Seems to me that doctors who work in ICUs and hospitals full-time will volunteer first.

A doctor with a private practice would have a hard time doing the quarantine part. If the first cases are handled well, it will not be necessary to ask many doctors to do this.

[kelliekat44]

28. Don't all of you understand that the moves by Christie and Coumo were intended to

show how they are strong leaders and the President is not? Just another opportunity for Christie "take charge." Mind you, I don't think a 21-day quarantine is a bad thing, but it can be done differently and certainly doesn't need a big press conference.