Ebola

We Already Have an Ebola Czar

It doesn't seem to be helping.

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As John McCain and other big-government Republicans call for an Ebola czar, The Federalist's Mollie Hemingway points out that we already have one—and that the office doesn't seem to be doing much good:

THE CURE

the federal government not ten years ago created and funded a brand new office in the Health and Human Services Department specifically to coordinate preparation for and response to public health threats like Ebola. The woman who heads that office, and reports directly to the HHS secretary, has been mysteriously invisible from the public handling of this threat. And she's still on the job even though three years ago she was embroiled in a huge scandal of funneling a major stream of funding to a company with ties to a Democratic donor—and away from a company that was developing a treatment now being used on Ebola patients.

Before the media swallow implausible claims of funding problems, perhaps they could be more skeptical of the idea that government is responsible for solving all of humanity's problems. Barring that, perhaps the media could at least look at the roles that waste, fraud, mismanagement, and general incompetence play in the repeated failures to solve the problems the feds unrealistically claim they will address. In a world where a $12.5 billion slush fund at the Centers for Disease Control and Prevention is used to fight the privatization of liquor stores, perhaps we should complain more about mission creep and Progressive faith in the habitually unrealized magic of increased government funding.

Read the rest here.

Bonus link: The Ebola debate, like so many debates, has turned into a face-off between the forces of Needs More Spending and Needs More Policing. They'll probably compromise and give us both. In the meantime, if Hemingway's article is an antidote to knee-jerk calls for more spending, this 2008 paper offers some good responses to the more-policing crowd.

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  1. The woman who heads that office, and reports directly to the HHS secretary, has been mysteriously invisible from the public handling of this threat.

    The why of it is answered in the next sentence.

    1. As I said, she’s currently in a powerpoint demonstration on Obesity and proper storage of guns in the home, and will be in those meetings all day… and will have limited access to email.

      Did I hit all the management bullet points?

  2. Let’s cross reference that list of people calling for an Ebola czar with who complained about all of Obama’s unelected czars.

    1. McCain is actually the first on that cross list.

      What we need is a COMMISSION. A COMMISSION STAFFED BY A BLUE RIBBON PANEL.

  3. The woman who heads that office, and reports directly to the HHS secretary, has been mysteriously invisible from the public handling of this threat.

    Dammit, Jesse, you *know* this is an ongoing investigation!

  4. We Already Have an Ebola Czar Scapegoat

    FTFY

  5. Avery’s Czar is a good beer.

    1. It is a superior Imperial Stout… The Kaiser ain’t bad either.

      1. Ja! Das stimmt!

  6. “The woman who heads that office, and reports directly to the HHS secretary, has been mysteriously invisible from the public handling of this threat. ”

    Uh-oh. Has anyone checked her temperature?

    1. I think she’s an asymptomatic carrier.

  7. THE ONLY CURE FOR EBOLA IS ROMANOV BONES.

  8. And she’s still on the job even though three years ago she was embroiled in a huge scandal of funneling a major stream of funding to a company with ties to a Democratic donor?and away from a company that was developing a treatment now being used on Ebola patients.

    And somehow, this person is going to be our savior?

  9. I may be an outlier, but IMO, the government is already doing about as good a job as can be expected “protecting” us from Ebola.

    There has been a grand total of ONE person actually contracting the disease in the US, and all of a sudden everyone’s freaking out.

    The airport screenings strike me as a totally unnecessary gesture intended to placate irrational fear.

    As far as I can tell the CDC is doing it’s job.

    1. “There has been a grand total of ONE person actually contracting the disease in the US, and all of a sudden everyone’s freaking out.”

      We have a very limited data set for transmission rates in the U.S., but if it can be transmitted that easily to healthcare worker despite the protocols that were in place, then that’s pretty alarming.

      The market selling off yesterday made a lot of sense, and if we get another case here, we’ll see another sell off. I’d expect airlines to sell off. I’d expect cruise lines to sell off.

      Given what little data we have, I’m not going to tell anybody to panic, but I’m not about to tell anybody it isn’t a big deal either.

      Epidemics happen.

      1. That health care worker was in physical contact with an Ebola patient who was critically ill and then died.

        The thing is there isn’t like a light switch that you suddenly become super contaigious the instant you get sick. This person got the disease from a person who was at the peak level of contagiousness.

        The only people who are likely to get the disease, at this point, are healthcare workers in direct contact. And let’s note the reason they caught this so early is because the healthcare workers dealing with Ebola are closely monitored.

        So it’s highly unlikely she gave it to anyone else. There was early intervention so chances are better she’ll live and not pass it on to anyone else.

        Even if she does, if the transmission rate is one new infected person per death, this will be a very slow spread.

        Babies are being born orders of magnitude faster than that. one Ebola death every two weeks vs. thousands of babies born every day. You’ll die of old age before the epidemic reaches you.

        1. “That health care worker was in physical contact with an Ebola patient who was critically ill and then died.”

          No shit sherlock. Hasn’t it been established that is how one contracts the disease from a contagious patient?

          That sentence is meaningless. It’s also meaningless that the person was critically ill and died. What matters is that the patient was contagious.

          “The only people who are likely to get the disease, at this point, are healthcare workers in direct contact. ”

          I’m thinking the opposite. Healthcare workers have personal protection protocols. Average Joe who gets vomited on is likely not wearing a face shield.

          You seem to think that every person who arrives in the USA infected with Ebola is going to be magically transported to a quarantined hospital room.

          “And let’s note the reason they caught this so early is because the healthcare workers dealing with Ebola are closely monitored.”

          Yes, and 99.9% of the population are not health care workers and so we can’t expect to be so lucky every time there is a transmission of the disease.

          “Even if she does, if the transmission rate is one new infected person per death, this will be a very slow spread.”

          The bubbling pot of Ebola (West Africa) which is starting to spill over is increasing at a staggering rate. (doubling every 30 days, more or less). Obviously, a spread of more than one infection per death is possible and a spread the opposite of “very slow” is also possible.

    2. ONE person has contracted ebola out of how many Ebola cases in America? 4 or 5? With maximum professional skill and precautions being taken. Whatever it is, that seems like a pretty high transmission rate.

  10. Before the media swallow implausible claims of funding problems, perhaps they could be more skeptical of the idea that government is responsible for solving all of humanity’s problems.

    Now you’re just being silly.

  11. The woman who heads that office, and reports directly to the HHS secretary, has been mysteriously invisible from the public handling of this threat.

    Why can’t you busybodies respect this woman’s privacy?

  12. “The Ebola debate, like so many debates, has turned into a face-off between the forces of Needs More Spending and Needs More Policing.”

    Given that the transmission rate between Ebola patients and healthcare workers–if the only vector really is bodily fluids–shouldn’t be much different than the transmission rate between HIV patients and healthcare workers or the transmission rate between hepatitis patients and healthcare workers, but is? I think we should start considering a third side in that face-off–people who suspect Ebola’s coming regardless of whether we have more spending or more policing.

    For instance, according to the CDC there hasn’t been one confirmed case of transmission of HIV from a patient to a healthcare worker in a professional setting since 1999.

    http://www.cdc.gov/hiv/risk/ot…..ional.html

    It’s safe to assume that healthcare workers, both here and in Africa, use protocols at least as good as those they use to protect themselves from HIV infection. In case no one’s noticed, those protocols don’t seem to be working (like they do with HIV and hepatitis), and that not only brings the protocols into question, it brings the vector assumptions those protocols are based on into question, too.

    I mean, if empirical data showing our protocols failing (compared to other diseases that travel the same vector) doesn’t bring our assumptions about the disease’s vector into question, what will?

    1. It is noteworthy that HIV can only survive outside a host for 15 sec, Ebolavirus much, much longer.

    2. If Ebola was airborne it would be spreading much faster.

  13. Given that the transmission rate between Ebola patients and healthcare workers–if the only vector really is bodily fluids–shouldn’t be much different than the transmission rate between HIV patients and healthcare workers or the transmission rate between hepatitis patients and healthcare workers,

    If you believe the official story, this is about right.

    Howevs, nobody ever went full hazmat on AIDS, so that should introduce a modicum of doubt.

    And nobody ever caught AIDS from the extremely light exposure (as in, taking off their hazmat) that people are catching Ebola from.

    Obviously, the official story that Ebola is essentially a bloodborne/direct contact pathogen is horseshit. I don’t think they know, yet, exactly how transmissible it is and how it is transmitted.

    Which strikes me as an excellent reason to throw down some serious travel restrictions until we find out.

    1. “Which strikes me as an excellent reason to throw down some serious travel restrictions until we find out.”

      At the very least, we should stop issuing visas to people coming from East Africa.

      …until we get a better idea what’s going on.

      1. West Africa, but your point holds. Add in a no-return policy if travel within those three countries or otherwise exposed to E. zaire, unless a 21-day quarantine is done first.

        One big difference between HIV-1/2 transmission and E. zaire transmission to medical workers is that the viral titers are much, much higher in end-stage E. Zaire patients than HIV patients. Compare ~1E6-1E7/mL at the outside for HIV to the 5E9/mL typical for Ebola. That higher concentration is going to mean that a lot less material can infect you (as say you might get from aerosolized fecal matter or vomit, or a microscopic droplet on the exterior of PPE) than would be the case for HIV. This might also explain why health care workers are getting the secondary infections in Western countries, and not other people in similar close contact situations, like Duncan’s girlfriend or her family in that apartment. The health care workers are the only ones around when the patient gets to that point of extreme viral load, so they’d be the only ones experiencing infection via a short ranged (1-3 m?) aerosol that might explain why nurses are getting this thing despite their so-so PPE.

        Note, I’m not saying true airborne transmission. That hasn’t been demonstrated yet by any of the Ebola strains (despite The Hot Zone, it still hasn’t been determined for certain that E. reston was transmitted through the air.

        1. Thank you for the correction.

        2. Thanks, Debbie Downer!

    2. It IS a bloodborne/direct contact pathogen. It’s just much, much more easily transmitted than AIDS. Meaning, you probability of getting it if you come into contact with infected blood, or even sweat is much higher.

      I don’t think anyone ever claimed you could get AIDS from sweat.

      1. “It IS a bloodborne/direct contact pathogen. It’s just much, much more easily transmitted than AIDS. Meaning, you probability of getting it if you come into contact with infected blood, or even sweat is much higher.”

        That statistic I linked to above, about how there is no confirmed case of a healthcare worker contracting HIV from a patient since 1999, there were a couple of things that happened about that time.

        1) They stopped flagging HIV patients.

        Nurses were letting their guards down when they were around patients who weren’t flagged. Now they assume every single patient is HIV positive. Contact with blood generally doesn’t happen anymore, except in surgery. …and even then, surgical protocols that protect surgery patients from infection also protect healthcare workers from patients.

        2) They made it against the rules for nurses to recap needles.

        Much of the risk to healthcare workers came from nurses recapping needles. The insurers wouldn’t cover them anymore unless the hospital started disciplining nurses for recapping needles as I recall. (Surgical nurses have to recap to maintain sterile fields, but they’re supposed to do it one handed).

        It should be noted that hepatitis is much more virulent than HIV, too–and yet the rate of hepatitis infection between patients and healthcare workers is also extremely rare.

        They’re doing at least the same with patients they know have Ebola, right?

      2. We’ve had one patient in this country. If it’s a one in a million shot that a nurse gets hepatitis from an infected patient, how many Ebola patients have we had in this country? …and that single patient infected a healthcare worker already?!

        Their protocols are failing. And they knew this guy was infected! …and the protocols still failed!

        They have another nurse in Spain, who contracted Ebola by treating some missionaries who had come back from Africa with the disease.

        That’s two! The first case in the U.S. infected a nurse despite the protocols, and the first case in Europe infected a nurse despite the protocols.

        Why would we question the protocols and the assumptions underlying them?

        1. “Why [wouldn’t] we question the protocols and the assumptions underlying them?”

          Fixed

        2. I too am a bit concerned that we had one (1) known case of Ebola and a healthcare worker that had contact with him and had knowledge of the situation contracted Ebola. That tells me that infection may actually be quite easy.

          1. And the same thing happened in Europe.

  14. perhaps they could be more skeptical of the idea that government is responsible for solving all of humanity’s problems

    Well, since governments are totally incapable of solving ANY of humanity’s problems and always in every situation, exacerbate those problems, then yeah, you’d think it’s about time the sheeple woke the fuck up to that realization.

  15. The United States government, if it would divert the funds from killing people all over the world and spying on all it’s own citizens, have plenty enough stolen loot to cure this disease. But the fact that they don’t give a shit makes that a moot point.

    1. No, Hyper, you can’t just throw money at the problem and magic up a cure. That’s a liberal, statist fallacy. There are many reasons for government to stop doing those things, but the stopping of those will not directly cause an ebola cure or vaccine to appear. But, yes, let’s stop doing those things and use some of that money to fund ebola research – several different, independent programs.

  16. But the LA Times said we don’t have an Ebola czar because of the NRA!

    Seriously, you can’t make up shit like that.

    1. I’m really sure that it’s only half the NRAs fault, the other half is global warming. Wait, is there room to squeeze Boosh in there somewhere?

    2. Ironically, when a lot of people see a headline about Ebola and the NRA, I bet it makes them think about going out and buying a shotgun.

  17. How did I know that LA Times link was Hiltzik? It’s like I’m psychic, sometimes.

    That guy is fruitier than a nutcake.

  18. Found her! She’s got a snazzie uniform.
    http://www.hhs.gov/about/foa/o…../aspr.html
    I think she’s a rear admiral.
    And she worked for the Rand Corporation, so she’s a fully paid up member of the Illuminati.

    1. Yes, RADM is Rear Admiral. Having said that, a uniformed public health service is a comic opera joke – the uniformed part that is.

    2. I was going to have fun with the “Rear Admiral” title until I looked at the pic. Naw.

  19. And for, what I call, fun – the budget for the Assistant Secretary for Preparedness and Response (trigger warning: PDF):
    http://www.hhs.gov/budget/fy20…..cation.pdf
    Go to page 14 for a simple table.
    Now, you’re saying to yourself, ‘I bet those awful ratbaggin, teafuckin, derpublicans cut this vital agency to the bone, leaving america defenseless in face of the dreaded blood plague from Africa.’

    Looking at the bottom of the table, the Czarina of Plague had in
    FY 2013: $553million plus $415m from the BioShield Special Reserve Fund = 968m;

    FY 2014 (just ended 10/30)appropriation: 1.243billion (even before any of that sweet BioShield Reserve/Slush Fund money).
    Nearly a $700million increase.

    I’m sure they spent is wisely.
    I know, I feel safer (she’s a rear admiral)

    1. You are doing Cthulhu’s work in some of America’s best neighborhoods, BP.

  20. Nothing.Left.To.Cut.

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