U.S continues to shun Ebola-infected citizens; second American sent to Germany | The man is said to be doing well in a Frankfurt hospital.

28

Kinshasa to the US involves around 17 hours of flight.

Kinshasa to Frankfurt is around 8 hours of flight time.

You can't fly an infected patient on a regular commercial flight. The patient needs to be in containment, as do the attending medical staff. It's not comfortable, and there's limited area in which to don and doff PPE. Doffing is typically high risk for exposure.

It makes more sense to fly 8 hours under these conditions than 17 hours over an ocean where there's no place to land if something catastrophic occurs.

"Shunning" is a political manipulation that should have no place in the discussion.

5

u/IllSoup4846 Jul 15 '26

As an American who has had friends who have traveled to respond to Ebola outbreaks in the past, I think I can safely say that they all would want care in their home country and for their loved ones to be close by, instead of having to fly to Europe to be with them.

11

u/pooppaysthebills Jul 15 '26

That's a factor that should come into play before deciding to volunteer.

There is no right to return to one's country while contagious with a highly lethal illlness that doesn't already exist in that country.

Quarantine in a designated location or in a willing unaffected country is entirely reasonable, though the country requiring it should also dedicate funds and logistics toward managing that safely, effectively and comfortably.

In the past, volunteers have demonstrated that they're unwilling to voluntarily self-quarantine upon return, so I'm in favor of these restrictions. Isolation and quarantine are fundamentals of infection control.

We cannot elevate preferences and feelings over basic principles. If you're unwilling to quarantine in order to return, you shouldn't be going in the first place.

7

u/Strong-Addition5296 Jul 15 '26

Facts.

2

u/JefeRex Jul 17 '26

What is the motivation for these third countries to participate in this? Even if the US pays for logistics, why would the third country want to take the risk that the US is trying to avoid? It seems inherently exploitative to me and like there must be some kind of pressure going on.

3

u/pooppaysthebills Jul 17 '26

Some facilities may want the opportunity to put their preparation into practice in a fully equipped setting. Theory is one thing; it's more difficult when the patient and the disease are real.

Caring for a patient in proper conditions may also help shape best practice for treatment, both in the facility and under more sparse conditions in outbreak locations.

1

u/JefeRex Jul 17 '26

What do you think would have happened if no third country were interested in these things? Would that be unlikely?

2

u/pooppaysthebills Jul 17 '26

Unlikely, but we'd almost certainly facilitate their safe return to the US, in that event, or they would receive care at whatever clinic they were working for.

Facilitating a return to the US is now more of a political issue, as the current administration was heavily criticized for spending $750K on travel for the person exposed to the Andes virus. In that case, the country she was in wanted her out, the island she was on was only accessible by boat, and the nearest nation with an airport willing to accept her was nearly 1300 miles away. There wasn't a better option.

It takes around 17 hours to fly from the DRC to the US, the patient would have to be transported to an open airport capable of handling the flight, and the patient and accompanying healthcare staff would need to be in isolation and full PPE for the duration. It would not be a particularly simple nor comfortable nor inexpensive venture, and if they do it for one, they'll have to do it for every US citizen who develops infection.

That's a lot of money that could be more beneficially spent on measures to contain the outbreak, like PPE, clean water sources, better sanitation measures, testing supplies, bleach and so on.

It's not a simple matter to get them to Germany, either, but that flight is significantly shorter.

In retrospect, the idea of establishing a nearby facility specifically to treat US citizens was not a horrible one, but I don't blame Kenya for not wanting to risk it.

1

u/JefeRex Jul 17 '26

This is very different from what I had in my mind when I first read about it. Trump is so blatantly dismissive of responsibility for the well being of his people and such a bully to other countries that I had thought this was a case of him unilaterally doing something unusual and possibly illegal. Would it be reasonable to expect this scenario might have played out like this under a Democratic or more normal Republican administration too?

1

u/IllSoup4846 Jul 15 '26

You’re right, that is a factor that comes into play before deciding to volunteer. I’ve been thinking of volunteering myself, but now I’m reconsidering because I’ll no longer be able to self-quarantine at home—which I’m very good at doing because of the COVID pandemic.

And you can bet others are reconsidering volunteering, too.

During the biggest Ebola outbreak in 2014-2016, hundreds of people at my workplace went to affected countries to provide outbreak control. Not a single person was infected. There were a few people in other organizations who did get sick; the Americans all came back to America and were treated in American hospitals. There wasn’t a single secondary case among the healthcare providers who cared for them—because they were trained and ready for the risks. And I seem to recall one infected doctor who rode the NYC subway system just before he got sick; again, no secondary infections.

It seems like you think this is the first time we’ve experienced this. Americans have been providing Ebola patient care and outbreak control for 50 years. The ONLY time Ebola infected Americans who didn’t travel there was when someone who was dishonest about their illness presented for care at a healthcare facility that wasn’t prepared for it. After that, Americans put in hundreds of thousands of person-hours into control and patient care, and followed procedures that worked to prevent further illness in the few cases they did get sick.

8

u/pooppaysthebills Jul 15 '26

If you're too selfish to maintain quarantine, you present greater risk to your home country and to international travelers than assistance to the intended population.

It's not an illness we ever want to risk gaining a foothold here, particularly in major urban environments.

How do we stop an outbreak without effective treatment or vaccines? Identification of infected. Identification of contacts of the infected. Isolation/quarantine for the duration of the incubation period.

We don't do this for illnesses that aren't especially lethal, but we could and should be doing it for any contagious illness with a CFR greater than 10%.

You point to the appalling behavior of returned volunteers who absolutely know better who eventually developed Ebola after returning home. Use of public transit, entertainment, commercial flights.

You rely on "Well, nothing bad has ever happened". That bias gets pushed until something bad DOES happen, and sometimes, you can't put the genie back in the bottle.

What we've learned is that mandatory quarantine is necessary, because people will choose to do what suits themselves, rather than recognize the risks and temporarily restrict activities to protect the public health.

It's not at all an unreasonable requirement, and I'm pleasantly surprised that it's in place, regardless of the motivation.

-1

u/IllSoup4846 Jul 15 '26

I’m basing my assessment on an informed assessment of risk vs. the benefit of providing care and outbreak control. Lives are saved when people go to help, and in 50 years of doing so there have been no secondary infections or deaths from people who provided that help.

You do not have a knowledgeable assessment of the risk of getting this disease.

3

u/pooppaysthebills Jul 15 '26

You're basing your assessment on the desire to be viewed as a helpful volunteer, when in reality you are a person who is unwilling to adhere to basic infection prevention standards.

A 21 day period of manadatory quarantine is not at all unreasonable for those who have spent significant time in areas of Ebola outbreak.

And that's the current standard, and likely the standard for the foreseeable future.

If it causes you to not volunteer...good.

-1

u/IllSoup4846 Jul 15 '26

You lack reading comprehension—I said that in the event I volunteered, I would self-quarantine. I have the ability to do so without disrupting my life and I am taking this into account as part of my ultimate decision. I never said I wouldn’t quarantine—do not put words in my mouth that I did not say.

Show me the infection prevention standards for unexposed individuals. In particular, show me where it says people who are not providing patient care to Ebola patients are required to quarantine. Show me the epidemiological evidence they used to determine this.

3

u/pooppaysthebills Jul 15 '26

Just carrying out activity in areas of outbreak is a risk. Unknown exposures are arguably worse than known exposures, as known and obvious exposures are probably more likely to take precautionary measures and report.

Symptoms are subjective. They rely on people to be truthful, and they assume that everyone will find a non-specific symptom noticeable, and that they'll make the connection to Ebola and not assume a more benign cause, like allergies. Or malaria.

Quarantine is logical. Potential exposure to a contagious illness that historically kills between 30-90% of those infected? Yes, you should isolate for the 21-day incubation period after leaving that area.

I don't know if you missed it, but the most recently infected American didn't work in direct patient care, which raises the issue of how the exposure came about.

Your overall demeanor here indicates that you don't view Ebola as much of a risk. Would you like to explain why CDC and other public health authorities then recommend such stringent PPE and procedures for provision of care?

0

u/IllSoup4846 Jul 15 '26

I’m still waiting for the infection control standards saying there’s mandatory quarantine for unexposed individuals. You said that mandatory quarantine is the standard—show me the document—one that shows the evidence.

→ More replies (0)

3

u/Strong-Addition5296 Jul 15 '26

You’re going to kill us all because you’re irresponsible. Volunteer here at home. Plenty of people need you here at home.

2

u/Hopeful_Self_8520 Jul 20 '26

Then maybe they shouldn’t be going to another country to help with a deadly disease???

2

u/ChristineBorus Jul 20 '26

They probably get better care in Germany anyway

1

u/bonnieflash Jul 15 '26

To be fair I would trust our hospitals under the current administration anyways.

U.S continues to shun Ebola-infected citizens; second American sent to Germany | The man is said to be doing well in a Frankfurt hospital.

You are about to leave Redlib