NFT: Nurse quarantined for Ebola monitoring will sue

that I didn't come back to this sooner but I put the infection rate formula link up as a joke. As someone who has worked with engineers, I happen to know there is a difference between a formula written on a blackboard and the real world application.

The real point of the matter is that some of you guys feel that something should be done but because the normal proper steps aren't drastic enough for your liking so you support this political pandering.

The normal procedures for handling Infectious diseases are more than robust enough to handling this in my opinion.

Especially given the difference in infrastructure and resources between America and Africa. Finally given the fact that there are well over 200 million people in the affected countries but only five thousand deaths thus far despite a poor infrastruction to fight and prevent contamination in some areas should tell you that the disease can be contained

is 3,000-49,000 per year, depending on how the calculations are done.

It depends on how they classify the diagnosis of death, and how much of a contributory factor influenza was.
Large range of influenza deaths per year - ( New Window )

In comment 11942225 Semipro Lineman said:

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that I didn't come back to this sooner but I put the infection rate formula link up as a joke. As someone who has worked with engineers, I happen to know there is a difference between a formula written on a blackboard and the real world application. The real point of the matter is that some of you guys feel that something should be done but because the normal proper steps aren't drastic enough for your liking so you support this political pandering. The normal procedures for handling Infectious diseases are more than robust enough to handling this in my opinion. Especially given the difference in infrastructure and resources between America and Africa. Finally given the fact that there are well over 200 million people in the affected countries but only five thousand deaths thus far despite a poor infrastruction to fight and prevent contamination in some areas should tell you that the disease can be contained

Absolutely it can be controlled, and there's no rationale for panic. The caveat is that it can be controlled if appropriate measures are taken. There might not be universal agreement on what appropriate measures would be, however, keep in mind that hospital workers who have taken what was deemed appropriate infectious disease precautions have been infected. Avoiding panic does not rule out prudence.

In comment 11942229 kickerpa16 said:

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is 3,000-49,000 per year, depending on how the calculations are done. It depends on how they classify the diagnosis of death, and how much of a contributory factor influenza was. Large range of influenza deaths per year - ( New Window )

Haha. I was just going to link this report. I think though, that the range you cited is for a 10-year period.

I'm linking the latest weekly report. Of note, we just started flu season and there's been one (pediatric) death this year so far. The number for last year was 109. IMO that makes this m ore serious than D68 which people are panicking about.

Link - ( New Window )

because I really want to go to the Caribbean soon. Or, I'll just wait because they're not all that far from making it Florida (at least Chik and Zika)

In comment 11942263 Bill L said:

Quote:

In comment 11942229 kickerpa16 said: Quote: is 3,000-49,000 per year, depending on how the calculations are done. It depends on how they classify the diagnosis of death, and how much of a contributory factor influenza was. Large range of influenza deaths per year - ( New Window ) Haha. I was just going to link this report. I think though, that the range you cited is for a 10-year period. I'm linking the latest weekly report. Of note, we just started flu season and there's been one (pediatric) death this year so far. The number for last year was 109. IMO that makes this m ore serious than D68 which people are panicking about. Link - ( New Window )

Bill,

I don't think it's for a 10 year rolling average. I think it's annual, because the CDC reports that, in 2011, there were about 53,000 deaths from the flu and pneumonia (National Vital Statistics Report).

It was 50,000 in 2010, and 53,000 in 2009.

the biggest of which is that they lump flu and pneumonia deaths together. As you may imagine, many people contract and die from pneumonia outside of getting the flu. There's no way to tease out the non-flu pneumonia numbers.

In comment 11942294 kickerpa16 said:

Quote:

In comment 11942263 Bill L said: Quote: In comment 11942229 kickerpa16 said: Quote: is 3,000-49,000 per year, depending on how the calculations are done. It depends on how they classify the diagnosis of death, and how much of a contributory factor influenza was. Large range of influenza deaths per year - ( New Window ) Haha. I was just going to link this report. I think though, that the range you cited is for a 10-year period. I'm linking the latest weekly report. Of note, we just started flu season and there's been one (pediatric) death this year so far. The number for last year was 109. IMO that makes this m ore serious than D68 which people are panicking about. Link - ( New Window ) Bill, I don't think it's for a 10 year rolling average. I think it's annual, because the CDC reports that, in 2011, there were about 53,000 deaths from the flu and pneumonia (National Vital Statistics Report). It was 50,000 in 2010, and 53,000 in 2009.

Yeah, it's clearer in the original paper. My math is really wonky today. I think I'm going home before I blow something up.

It wasn't clear at all.

I had to read, re-read, and then re-re-read.

They never used the word "annual" in there once, and had, as a time frame, 1976-2007.

Until I figured out it couldn't be 10 deaths from flu each year and found other stuff was when I put it all together (on my 4th reading).

...that kicked this whole thread off was instituted to gain the nurse's release. I see no mention anywhere of suing for dollars. That was, of course, automatically assumed by some on this thread (myself included) until I read the linked article.

It would have served a better purpose for the OP to have stated this in the opening post.

In comment 11942609 BMac said:

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...that kicked this whole thread off was instituted to gain the nurse's release. I see no mention anywhere of suing for dollars. That was, of course, automatically assumed by some on this thread (myself included) until I read the linked article. It would have served a better purpose for the OP to have stated this in the opening post.

huh... i put the whole article in the first post... i never mentioned money or anything...

being treated like this..

In the debate about to quarantine or not. The argument is doctors and nurses will be more reluctant to go over to help. Let me get this logic straight....so your such a great, human, loving. person that you will go. You will leave all that you know behind. You will risk your life daily. You will face an unseen killer who can creep in at anytime to help people you have never met, because you are so good. But-you won't go into guarantee when you come back to save your own country, friends, child? Yeah makes sense to me.

smh

In comment 11942637 GMAN4LIFE said:

Quote:

In comment 11942609 BMac said: Quote: ...that kicked this whole thread off was instituted to gain the nurse's release. I see no mention anywhere of suing for dollars. That was, of course, automatically assumed by some on this thread (myself included) until I read the linked article. It would have served a better purpose for the OP to have stated this in the opening post. huh... i put the whole article in the first post... i never mentioned money or anything...

GMan...The point I was (poorly) making was that as soon as people hear "lawsuit" they immediately associate it with dollars. Some of the posts near the top of the page reflect this. I contend that not stating that the suit was non-monetary set the thread up for the usual lawsuit rants. Fortunately, the thread was steered into the hysteria angle and was saved.

Nothing personal.

people won't go into quarantine - it is the hassles that go along with their return. Most doctors that volunteer for these things do it on their own time off. Last thing they need is to come back and have another three weeks before getting back to work, which will also beg the question about how receptive will their employers be to having them out not just for the time n Africa, but also for nearly a month upon their return.

I've already talked to some doctors who said it definitely is going to be a factor if the crackdowns continue.

In comment 11942650 GMAN4LIFE said:

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being treated like this.. In the debate about to quarantine or not. The argument is doctors and nurses will be more reluctant to go over to help. Let me get this logic straight....so your such a great, human, loving. person that you will go. You will leave all that you know behind. You will risk your life daily. You will face an unseen killer who can creep in at anytime to help people you have never met, because you are so good. But-you won't go into guarantee when you come back to save your own country, friends, child? Yeah makes sense to me. smh

Yes. Believe it or not, people respond to the treatment they receive when undertaking actions.

If you're treated as a prisoner when you return with a draconian quarantine, it disincentivizes the people to go through the hassle of helping others.

When you increase the expected costs of an action, you decrease the likelihood with which people will undertake the action.

It's the same reason people don't help during natural disasters when federal agencies impose more stringent guidelines on what you can do to help. It doesn't make the people any less benevolent, but changes their cost calculus.

In comment 11942660 FatMan in Charlotte said:

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people won't go into quarantine - it is the hassles that go along with their return. Most doctors that volunteer for these things do it on their own time off. Last thing they need is to come back and have another three weeks before getting back to work, which will also beg the question about how receptive will their employers be to having them out not just for the time n Africa, but also for nearly a month upon their return. I've already talked to some doctors who said it definitely is going to be a factor if the crackdowns continue.

yea that may be so but this is a big deal. I mean people have died with this disease and the spread can be worse if we dont make drastic decisions. The fact to ask someone to self quarantine just for 21 days to make sure they dont have any of the symptoms isnt a tall order. Again, the doctor in NYC could have disproved this but unfortunately, he didnt.

What about support staff, like nurses? Or other volunteers who have less experience, and can likely less afford to be gone for that amount of time without pay?

new guidelines should be in place for these people. They should still be paid for their time in quarantine. It sucks but its the reality now.

In comment 11941612 oke49 said:

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many many years ago I served as health officer for my tiny rural County here in Florida.I can remember quarantining individuals and families. It is a necessary part of medical care.this whole debate sounds like one big case of begging the question. That is, they're not addressing the real issue. These folks claim that the quarantine is violating their human rights, that it is illegal, and it is a civil rights issue, and on and on. It's quite simple. It is a public health issue. I wouldn't mind if they served the quarantine at their home with monitoring. But some form of quarantine is necessary.this is what happens when you get a bunch of lawyers dictating on a health issue. Aside from governor Christie opening his big mouth about the patient's condition, I applaud what the Governors have done. This is political correctness gone amok. I respect Dr.Fauci. I studied his book. He of all people should know some form of quarantine is indicated.

You miss her point completely. She is more important than anyone else and asking her to give up time from her very important life is too much of an imposition. Who cares if anyone else contracts Ebola and dies an agonizing death, she's got shopping to do. Community-minded folks like yourself just don't get it. She counts and nobody else does.

else noticed how quick people here are to give up other people's rights?

It's a just and necessary hardship that we're asking you to endure for the sake of our peace of mind. Never mind civil rights and crap like that. They're not important right now because this violation is something that doesn't directly effect me

than a tent structure outside the University Hospital in Newark.

In comment 11943536 spike said:

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than a tent structure outside the University Hospital in Newark.

This

Which most of the people have been saying.

Loonies will be loonies.

"I don't plan on sticking to the guidelines," she said. "I remain appalled by these home quarantine policies that have been forced upon me."
http://www.cnn.com/2014/10/29/health/us-ebola/index.html?hpt=hp_t2 - ( New Window )

yep... she is a winner

opting to use other procedures that have a similar basis in science.

Self-reporting several times a day.

I'd prefer the 21 day home quarantine, but the other measures are not without basis (Doctors Without Borders recommends the less restrictive reporting procedures).

.

...

Yes, Eric Duncan died, but he was a special case--first case here, allowed to go home, not protocol for experimental drugs or serums made from blood of survivors yet, etc.

Other than that, there have been 7 US cases reported, and exactly zero deaths. The reasons why are clear--link.

If the infection rate stays low (as is very likely) and the death rate from those infected also stays low (as is also likely), perhaps the grownups in government will take over the discussion. So far they are losing: Hagel is send troops to West Africa to help, and then is quarantining them when they get back. A two star general was recently quarantined, despite a lack of symptoms.
Link - ( New Window )

dealing with patients that had ebola and then getting ebola is the problem.

if the science suggested that he put anyone at risk. There is no evidence that he did.

He self-monitored, and the only question is whether the teeny-tiny symptoms he had the night before he turned himself in put anyone at risk. Risks go up as symptoms go up, and you still only get ebola if a contact with body fluids took place. There is no evidence that one did.

Ebola training and conference at the hospital. We do have some employees that work at one of the designated hospitals as well as ours. I think the nurse is being stupid in her lawsuit. If you work with an outfit such as Doctors without Borders, you have to realize the jeopardy you could potentially be in, when you are working with such a deadly disease. If I were her, and I returned from a mission on W. Africa after helping Ebola patients, I would not have a problem with a quarantine, as long as, I knew in advance, when I got back to the US, that everything was already set up. I would not have a problem in quarantine until I were cleared. I would not want to endanger any loved ones or anyone else for that matter. However, it needs to be handled well. I don't know exactly how it was handled in her case. She stated being treated like a criminal. She could just be a selfish person, or it was greatly mishandled or somewhere in between.

the evidence as to how badly she was treated is all over the Net, as well as on TV. Kept in a tent with concrete floors, no shower, non-flush toilet, no reading materials, no TV, with the clear inference that she would be kept that way for 21 days. And that was after the aggressive criminal-like treatment at the airport.

And, there is no evidence in the science that home self-monitoring as a form of quarantine is insufficient. I suspect that her lack of willingness to comply with that is because she was pissed. I disagree with her, but understand what drove her.

unfortunately, I spend too much time at the hospital to even glance at the news or internet. Finally have today off followed by a 10 hour OR gig tomorrow. So yes, if that is the case, it was handled beyond poorly.

at the hospital where I am... quarantine would have been sooooooo much nicer. And yes, manh... I agree with you. I get what drove her, now.

I find that a bit worrisome in a nurse. Is it overkill, probably. But she should understand the issues involved and be cooperative.

I heard that in Bellvue they had to transport a whole bunch of patients to another hospital because of the one Ebola patient he had. Even if it's not that contagious, the amount of precaution that has to be taken makes each case a huge problem.

In comment 11946770 manh george said:

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the evidence as to how badly she was treated is all over the Net, as well as on TV. Kept in a tent with concrete floors, no shower, non-flush toilet, no reading materials, no TV, with the clear inference that she would be kept that way for 21 days. And that was after the aggressive criminal-like treatment at the airport. And, there is no evidence in the science that home self-monitoring as a form of quarantine is insufficient. I suspect that her lack of willingness to comply with that is because she was pissed. I disagree with her, but understand what drove her.

She's now vowing not to observe a home quarantine.

at which point, they'd likely be too sick to go out. Again, so much of this is much ado about nothing. If the nurse has not exhibited any symptoms, why should she have to observe any quarantines?

.

I just said that. If you want to quote what I said, please read it first. Thx.

In comment 11946703 manh george said:

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if the science suggested that he put anyone at risk. There is no evidence that he did. He self-monitored, and the only question is whether the teeny-tiny symptoms he had the night before he turned himself in put anyone at risk. Risks go up as symptoms go up, and you still only get ebola if a contact with body fluids took place. There is no evidence that one did.

IMO, that's a tough argument. There's no evidence that he put anyone at risk because (apparently) he didn't. (Of course, we don't know how his contacts will turn out either yet). However, he always had the potential and he knew that. There's still a lot of question as to degree of symptoms and infectivity. Is it none until you are symptomatic or is it now no infectivity until you are beyond the teeny tiny stage? There simply aren't well-defined, well-controlled studies. I did see something today where they were touting a new pcr test for ebola that is detecting virus in the blood well before a person becomes symptomatic. Again, no correlation with being contagious but if there is detectable virus in the blood then it does present at least the possibility of transmission. IMO, if you know you're potentially infected, you should be a responsible person.

In comment 11946801 Section331 said:

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at which point, they'd likely be too sick to go out. Again, so much of this is much ado about nothing. If the nurse has not exhibited any symptoms, why should she have to observe any quarantines?

What is the window? If you're criterion is fever, presumably you can be below the (arbitrary) temperature threshold one second and above it the next. Do you become infectious right at that point? Ten minutes later? An hour? A day? Where is the data.

In comment 11946814 manh george said:

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I just said that. If you want to quote what I said, please read it first. Thx.

It wasn't clear in your post whether you were referring to her new quarantine. Stop being so touchy.

but the science I have read suggests a reasonable window: significant time after you get a moderate fever like 100 and the onset of symptoms that are more risky to the general population.

Health care professionals, in particular, should be OK with home quarantine and self-monitoring. The NY doctor, in this case, should have been subject to more specific protocols for home quarantine, I think, but the risks don't appear significant.

Ebola is still difficult to transmit--not-without body fluid exchange--and at this point no one is dying. Imo, we need a national protocol of home quarantine with monitoring for anyone who might have been in contact with Ebola patients in Africa. No more, no less.

In comment 11946815 Bill L said:

Quote:

In comment 11946703 manh george said: Quote: if the science suggested that he put anyone at risk. There is no evidence that he did. He self-monitored, and the only question is whether the teeny-tiny symptoms he had the night before he turned himself in put anyone at risk. Risks go up as symptoms go up, and you still only get ebola if a contact with body fluids took place. There is no evidence that one did. IMO, that's a tough argument. There's no evidence that he put anyone at risk because (apparently) he didn't. (Of course, we don't know how his contacts will turn out either yet). However, he always had the potential and he knew that. There's still a lot of question as to degree of symptoms and infectivity. Is it none until you are symptomatic or is it now no infectivity until you are beyond the teeny tiny stage? There simply aren't well-defined, well-controlled studies. I did see something today where they were touting a new pcr test for ebola that is detecting virus in the blood well before a person becomes symptomatic. Again, no correlation with being contagious but if there is detectable virus in the blood then it does present at least the possibility of transmission. IMO, if you know you're potentially infected, you should be a responsible person.

+1

I do have problems with the doc going out bowling, the nurse flying and, especially, the nurse leaving for a cruise. Home quarantine and regular monitoring seems reasonable to me.

themselves added a bit to the confusion. The rule on airline travel was a fever present at any level and the fever present to be deemed at risk for ebola was 101.5.
That was last week so as they change it seems every day it could have.

My understanding was in NY(I don't know NJ) the person was allowed self quarantine at home if they had one to go to with limited exposure allowed. No parties any of that but close family 2 or 3 was OK. Conn it seems that is what they are coin though that is not in the new much. If you did not have a nearby home to go to was when it got sticky. NY said medical facility…I don't know NJ.

The self quarantine at home was accompanied by a check by PD by a visit or by email or phone.

There is not a perfect response to this. But if say they have to move 10 patients and check on a 100 people for a exposure if this stuff is not done, and someone gets a fever...not to mention the losses potentially to small businesses, a lawsuit any small amount lost would likely be overwhelmed by the costs of not quarantining at all.
To my opinion.

No reason for hysteria but it still is a real thing.

where a man returning from West Africa has been placed at the State's expense into voluntary quarantine. He stated he went to help with the crisis there, but is not a licensed physician in the state and was not affiliated with any known NGO. His actual contact with infected patients is believed to be neglible if any, and he is not exhibiting any symptoms.

Almost sounds like a wacky guy who wanted a free place to stay for a few weeks.

article - ( New Window )

another nut job to complicate the situation.

REminds me of 9/11 how many nut jobs went over or tried to get over thee to find OBL…I remember several.

Crisis seems to bring them out of the woodwork.

do as we say….

"U.S. troops returning from Ebola-stricken nations will be isolated for 21 days, Defense Secretary Chuck Hagel announced Wednesday, a day after the White House raised concerns about states imposing strict quarantines of health care workers returning from West Africa."