The Dallas events re Ebola are actually weirdly reassuring, and are strong evidence ... [View all]

[Whiskeytide]

...that we will NOT have an outbreak in the US.

First, prayers and good vibes to the nurses who are infected, and all hope is extended to them for a full recovery.

But here's why I'm beginning to understand what's happening:

All Americans have heard or understood about this virus for the last 20-30 years is that it is super contagious, incurable and practically un-treatable, wipes out entire villages so fast that it doesn't usually spread beyond the bush (the old "it's so deadly it's not a threat to us" meme), but ... (dah, dah, DAHHHH) if it ever gets going here, it would be a nightmare pandemic. We all saw the movie, right?

Fortunately for us, it was always a problem in Africa. Meh. Lemme know when it gets here and has infected a Kardashian. Then I'll give a shit.

Now - it has shown up at a Dallas hospital. A DALLAS HOSPITAL!!! I think Dallas is in the US!! In fact, I'm pretty sure it is. Uh oh. We're all gonna die!!! Death by hemorrhagic fever. What a way to go!!! Worst day ever! Did you see that freakin' movie?!!!

But then, the CDC and other "experts" - even the ones here at DU (the most trusted source of civilization ending events) - start telling us to chill. Don't panic. Its not that contagious, and we're not likely to have an outbreak in the US. WTF???? How does that jive with what we think we know about this bug? I mean, shit, we ALL saw the damn movie, right?!!!

So - the natural conclusion is to assume the government and health care experts are lying to us. We ARE all gonna die a horrible, bleeding from the eyes death, but they don't want a panic on their hands until they have the quarantine camps and the coffins and the corpse disposal ovens and all that shit ready for the carnage. Donald Southerland is in charge of it all! Damn. I wish I HADN'T seen that scary-ass movie!!!!!

But what's the evidence telling us?

So far - NONE of Duncan's pre-hospitalization contacts have been diagnosed. Not even the fiancee and other occupants of the apartment who had CLOSE contact. I know we're not past the possible incubation period - but we're well past the likely incubation period, and every hour that passes looks good for those people.

But then, two health care professionals are diagnosed. All within a week of Duncan's death. HOLY SHIT!!!!! Get me some plastic, duct tape, canned goods and ammo (in case someone tries to take my plastic, duct tape and canned goods), I'm running for the hills!!!!!!

But here's the thing. The apparent inconsistency of the pre-hospital contacts seeming to be clear, and the nurses contracting the disease, tells us a lot. This disease, like most viruses, has varying potential for transmission - depending upon when you have contact with someone who is infected. Well, duh. I should have thought of that before, but I was too busy putting out my hair.

In the early stages, the virus is hard to transmit. It is fragile outside the body, and you have to come into direct contact with the bodily fluids to contract it. In other words, you've got to go swimming in vomit and feces to get it. Thus - none of Duncan's pre-hospitalization contacts seem to have it. And remember, Duncan was sent home after he started having symptoms - and still it's not looking like his contacts at the apartment have been infected. The virus was certainly there, but not in high concentrations.

But in the later, final stages of the disease, apparently the infected patient's body is quite literally crawling with the Ebola virus. It is still fragile outside the body - but the sheer numbers, as well as the increased presence of contaminated bodily fluids, make transmission significantly more likely. Thus, we have nurses that are caring for Duncan become infected - because they were there to the bitter end with a patient who was spewing high concentrations of Ebola via explosive diarrhea and projectile vomiting.

Now - don't get me wrong. There were lots of problems with our state of preparedness - from the top down - and it should not have gone down like it has. We HAVE to get better at handling this. But it does seem to explain why the nurses were infected when the fiancee was not. It was the stage of the disease at the time of exposure.

In Africa, the sick are more likely than not cared for by friends and family until death, or at least until close to the end stage of the disease. Then the bodies are handled by friends and family through the burial process. Thus, we have untrained and unprotected exposures at the most contagious stage of infection. Those people are, figuratively at least, swimming in Ebola. Its no wonder there is an outbreak in West Africa that will get much worse before it gets better. And every country on the planet needs be pitching in there to turn it back. THAT would do more to protect all of us than all the plastic and duct tape at the all the Walmart stores in the world.

In the US, by contrast, most (most) of those who get sick end up at a hospital much sooner. They are likely to be isolated and undergoing treatment before the final stages of the disease are reached. Transmission from casual contact prior to hospitalization (like on an airplane, or from a doorknob) or even in the early stages of hospitalization (like in a waiting room or at a Doc-in-the-Box) is just not very likely. Possible, I suppose, but not likely. I don't think we have a single well documented case of such casual transmission. Not that I have seen, anyway.

Does it mean there can't be an outbreak in the US? No. We can all imagine nightmare scenarios (personally, mine is that when Duncan's vomit was power washed from the sidewalk into the sewer, it infected a couple of rats, and now there are millions of rats teeming with Ebola about to come streaming into the streets of Dallas any minute now - wouldn't THAT make a great movie??).

But I now think I understand why the experts say it's not likely to result in an outbreak in the US. It's not - and that's based on how it has played out in Dallas despite the mistakes and incompetence. The biggest risk in the US is to healthcare professionals, and they need to get up to speed quickly. And people need to get themselves in for treatment (that's a whole other topic, I know, I know).

Hopefully it stops at these two nurses. But it seems safe to say that the "Duncan as pt. zero" scenario is, for now, most likely contained in the healthcare arena. For the general public, that's weirdly reassuring.

My $0.02. Now, I'm going to go put on my flame resistant suit.