Friday, October 31, 2014

Ebola and AIDS

As of Oct. 25, the World Health Organization reports that 450 health care workers have contracted Ebola this year and 244 have died. The administration has taken the position that temperature monitoring is predictive and adequate yet there is actually strong evidence that is not true. One in seven people infected with Ebola doesn't have a fever before diagnosis. Data on over 4,000 Ebola cases — the most complete analysis ever — published Oct. 16 in the New England Journal of Medicine show that 13% of patients don't develop fever early on. Self-monitoring is also seen as beneficial; relying on returning doctors and nurses to monitor themselves assumes they will catch any sign of illness quickly and avoid spreading it. But the New England Journal of Medicine research found doctors and nurses with Ebola don't get to the hospital sooner. And that certainly squares with the original Reston experience.   
But there clearly is more going on here than science and epidemiology. Thomas Frieden, the head of the CDC,  in response to the move by several governors to create quarantine programs for doctors and nurses returning from West Africa, said that isolation would be a "stigma" and make them "pariahs." Stigma? Pariahs? These people are willing to sacrifice a lot of accuracy for some principle that is hard tor the rest of us to define. It is very reminiscent of the campaign to characterize AIDS as a heterosexual disease. What is the important thing here?

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