Sunday, August 26, 2018

This Is Why I Blog

This kind of insightful, rational commentary response to a post warms my heart. It really does. It's like when I'm working, and someone comes to the ER, and then wants to tell me and the doctor and everyone else how to do our jobs. Except here I don't have to worry about a low Press-Ganey score from the snotty drug seeker we wouldn't give any Norco to, or a shitty rating card from the psych patient we shipped out to the whack-job ward in hard restraints and a spit mask.
"Wow. Alarmist much?

The key things that will contain an Ebola outbreak in Europe, North America, etc., is communications.

Where rural level Africans are very hard to convince about the dangers of spreading disease, there won't be much such issue in Europe, North American, Most of Asia, Most of South America. People are educated (enough) to know what is right and wrong. (Recall the SARS and H1N1 outbreaks - hygiene went up 4 notches).

Get the word out, and people will avoid people. People will up their hygiene game. Etc. Can't spread w/o bodily fluid contact.

So there will possibly be other Texas Health Presbyterian Hospital events. That did not result in a pandemic. At all.

Of course it's not the CDC saying "we got this". It's people with information who will say, "Stay the f--- away from me, dude!" that will burn out a pandemic quickly. (Indeed, the CDC will probably say, "Tell people to stay away.").

In that sense, planning and preparing now (true prepping, not the arm myself to the rafters with AR-15 prepping) is a much better tool than alarmist articles as above. (And you don't need to repeat "bleeding from the (orifice of choice)" so often to make a point).
Oops, left out a detail.

Vaccinations are now available for Ebola and one is in use in Africa following the "ring vaccination" protocol (vaccinate highest risk people). It is (apparently) effective (if not 100%) even on patients who have contracted Ebola."

When the house is on fire, perhaps pulling an alarm is what's called for.

But hey, thanks for letting us know that life will go on fine, once everyone realizes they can't go to work, school, church, the mall, the grocery store, the gas station, the pharmacy, the bank, the ATM, or anywhere else, nor touch anything they haven't disinfected with bleach and sunlight for 10 minutes, after gowning up in the equivalent of MOPP IV, including N95 respirator, head to toe disposable overgarments including hood, goggles, and face covering, rubber booties, and two pairs of gloves, and following a strict series of decontamination again when they remove the garments, any time they venture outside their perimeter (God knows why they would, other than oh, I dunno, the exact food, water, medicine, money, and all those other luxuries we can skip for a few months/years). Or else stay locked up in their homes with food, water, medicine, and such, for at least 40+ days after the last reported case, nor come closer than 20' to anyone coughing or sneezing until 10 or more minutes have passed to let the droplets settle, if they're crazy enough to go out at all, for any reason whatsoever, because that won't affect the largest economy in the world in the SLIGHTEST, will it, jackass?

Do you have a spare two years' income handy? In cash?
Do you have twenty-four months' food at home?
The 2013 outbreak wasn't over until 2016 in West Africa.(But, you knew that, right?)

And you've also got a 40' ISO container full of limitless supplies of HazMat gear, and an incinerator and fuel to dispose of used gear properly?
And hundreds of gallons of bleach? And a sprayer for it?
Who's going to spot for you putting it on and taking it off?
Or were you just going to wing it?

Who's going to run the water plant when everyone stays home?
How will water get pumped when no one comes to work at the power plant either?
Who's going to fill up barrels and distribute water door to door when there's no gas, no water supply, and no power? You?

How many cops and firemen will come to work at all, let alone when they have to work in gear so hot you can't do it for more than a couple of hours?

Who's going to be giving those vaccinations when no one comes to work at the hospital, for all the reasons outlined above?
(Oh, BTW, as the name would imply, "ring vaccination" isn't vaccinating "those at highest risk" - that would be medical relief  workers, primarily, and probably be called "highest risk vaccination" - it means vaccinating those proximately closest to those already infected, i.e. family, neighbors, friends, and other closest contacts, and putting a literal ring of immunized people around the outbreak. Plain English is funny like that: it tends to mean what it says. If you're going to be the smartest guy in the room, and sling the terms around, it's probably a good idea to get them right. Just saying.)

What happens if it doesn't work so well? If your weasel-worded ("apparently") morphs into "Whoops, my bad, not so much..."

What are you going to do with the 25% idiots who won't even get vaccinated now?
Shoot them?
Round them up?
Ignore them and let them die?
And merrily spread the outbreak in the meantime?
What about their minor children?
Do we just let mommy and daddy give them Mr. Jones' nice cup of kool-aid? Because father knows best?

As a certifiable jet-fuel genius technocrat with all the answers, tell us how to deal with that.

And then you're going to do...what, exactly, about those 75M dead bodies, from Ebola, in some cases, but also from heart attacks, dehydration, heatstroke or freezing to death, running out of their meds, not to mention what happens when any semblance of civil government breaks down and blows away in the wind?
Who's going out on body pick up and disposal?

What are you going to do about the 20% of America on anti-depressants and other psych meds when they run out?

Who you gonna call when there's no power for that information grid, TV, radio, cell towers, or the internet, about three days after this hits any place, and the lights start going out?

Oh, say, your buddy Chip Diller called.

In 2014, with exactly that sort of "We can do this!" thinking, Texas Health managed, despite the CDC's sub-standard "protocols", to infect 2 ICU nurses, despite more information, protective gear, and better training than you've got right now, and exactly doubled the US outbreak in less than 21 days, while exposing thousands more to the potential to become the next wave, shutting down schools, completely closing that entire 968-bed major hospital in our 9th largest city for one patient, and spreading the exact amount of fear and panic totally justified when TPTB turn out to be so stupid, incompetent, and recklessly dismissive of the public's safety and best interests.

So, wow.
Totally fucking ignorant of reality much there?

And just to help your reading comprehension along, notice where I said that this Congo outbreak now isn't nearly as bad now as it was in West Africa 2014. Yet.

But the post was in reply to someone, a trained medical professional, in fact, who - exactly like you - didn't think this was that big a deal at all.
So I'm guessing the return fire landed inside your perimeter, and you're running critically low on butthurt creme, right?

Yes, this outbreak can be dealt with.
Even if it gets here.
A good start would definitely be getting a better grip on reality than what you've got.
And certainly not by the pig-headed arrogance displayed in 2014, which was the exact point of the whole post, not alarmism.
I wasn't throwing a hand grenade in the outhouse just to watch the shit fly.

In fact, far from anything alarmist, all I did was recount what happened last time, and suggest a number of ways to not be that fucktarded the next time. I didn't advise napalming Africa, forting up and heading for the hills, establishing a colony on the Moon, nor anything else as silly-assed as your disdainful reply would engender.
I spoke simple common sense on both the past, and looking forward, and that somehow roils your inner child's clueless disconnection with reality.

Well, pardon me all to hell.
I'm sorry for dragging you to this site, and forcing to read common sense at gunpoint.
Oh, wait.
That didn't happen, did it?

Hunkering down at home may indeed be the best option, if it gets here this time.
Frankly, I'm far more interested in making it much less likely to ever get here again.
But hey, you go on perfecting your pedal-powered water bailing machine, and I'll just focus on us maybe not running the ship into a fucking iceberg, m'kay?

Acting like hunkering down would be simple, or just an extended Superbowl weekend is the height of jackassical ignorance.
Ignoring the actual second-, third- and fourth-order follow on results is just plain head-up-the-ass full recto-cranial impaction.

So thanks for dropping by. (And obligingly putting that big "Kick Me!" sign on your back!)
Maybe if you read another post here someday, you could try next time with your eyes open, the batteries for your brain fully charged, and your mouth in neutral.
Just for the novelty.

This was yours, I believe...


Allen said...

Math can be too hard for some. According to the poohbahs the R0 for ebola is about 2. Suppose it becomes 4 due to the nature of our society? "Whoops my bad." From what I've read we don't even have a real handle on the infectiveness of ebola yet, let alone much else in dealing with it in widespread infection. "My plan takes no account of my ignorance," ain't much of a plan.

You never get just one Horseman of the Apocalypse, you get them all.

Aesop said...

True enough, but what color horse does Stupidity ride in on...?

Anonymous said...

yup, pretty easy, tones go out for a sick PT. FIRE and EMS show, with gloves, glasses and N95 mask. will they wear the PPE, maybe. 2-5 personal contacted, not to mention the family and ER staff. continue, medic rig and fire truck clear. head to next call, head to station, head home, or grab bite to eat...exponential component goes vertical real quick. 100% with you.

MMinWA said...

These ass kickings are definitely harshing my mellow-if ebola shows up in w Texas, hunkering down is the only path I'm seeing. There's a good group here in my AO but this is only our immediate vicinity.

We've got supplies but not 2 years worth. Besides the water will be gone long before that.

Anonymous said...

Thank you for that, I couldn't manage that sort of rebuttal.

I was temporarily assigned in SA when that hit the fan the last time. I reckon we did not dodge a bullet. Hell no. We just stood there a pillar of bureaucratic fake-salt and the VHF bullet, like a SMOD, just happened to miss us. Neither luck nor skill was involved.

Anonymous said...

Aesop said - True enough, but what color horse does Stupidity ride in on...?

...I'm guessing, pussy-hat pink or Hillary-bile chartreuse.

Stealth Spaniel said...

Terrific rebuttal, full of wit and sarcasm. Just what the nurse ordered. Some -thing- is what I fear will really kick off WW3: a pandemic. Ebola is one of many, although good enough for the festivities. Escaping Africans, who unleash every known carcinogen on Europe or the US, are certainly up for nomination. What about the Muslims from every known dirty place on earth? It's not like we delouse anyone at Ellis Island anymore. Children of illegals are immediately thrown into school, along side your clean & vaccinated children. (Some diseases don't have a vaccine to prevent them from happening). These same kids are interacting with teachers, administrators, etc and guess what families/neighborhoods/businesses are also interacted with? It's how a pandemic starts, and I am always surprised terrorists haven't tried such a method. Or maybe they have without success-yet.

Jennifer said...

Regarding the above, the boatload of african 'refugees' that Italy was refusing to allow to disembark have TB. The courts forced the govt to allow them to disembark on grounds that refusing was the same as 'kidnapping.' There was no question of sending them back; Europe is welcoming the pestilence with open arms.

IN RN said...

I have worked healthcare for over a decade, in various facilities. All it takes is thinking about the spread of C-Diff to realize that we are well and truly hosed in/when Ebola gets here.

AB.Prosper said...

I don't think anyone other some guys with wells and either manual pumps or a lot of gas has what 4000+ gallons for a family of 4?

Lots of people have food and storing a couple of years food while expensive is actually pretty easy but water and medicine are much bigger problems.

Anonymous said...

Question about vaccines in general, and the Ebola one specifically.

I Have a hard time believing many of the ever increasing number of vaccines are effective or not,harmful. I’m pretty sure I will draw your ire, but I’m curious about your take on this. My take is this: 1. Blanket liability from harm for vax makers and those,who dispense them. This is a big red flag. Also the fact that the courts rules that vaccines are absolutely unsafe as part of what led to this blanket immunity stance for the vax makers. 2. An ever increasing number of vaccines, many for diseases that don’t cause harm in the vast majority of people. This seems nothing more than a naked money grab. I think that this “vaccinate against everything “ profit making strategy is going to backfire magnificently- if modern “science”, aka, peer reviewed not the scientific method type science of old continues, we’ll see how poorly opinion as a science fares with regards to unintended consequences.
3. Herd immunity - read of only one study attempting to prove herd immunity with vaccines, I think it was measles vax in Baltimore in the 60’s, and the posit was 50% vax rate would = herd immunity, but turned out to be wrong. Eventually led to researcher saying 100%vax rate was needed for,herd immunity- which tells me no such thing is possible with vaccines. Herd immunity does exist, but only among populations with natural immunity so far. There is so much fud on both sides of the equation, it is hard for,lay persons to really get a bead on what is the truth. So, I,have to look beyond the pro/con to..
4.i have a problem with aborted children being used to create vaccines, you can’t protect life with death. You don’t make something unholy holy just because you say so. Lots of vaccines have unclean or unhealthy components incorporated.
5. Autism. This one is all sorts of screwed up, on both sides. I wonder if autism is just an occasional symptom of something more problematic with regards to stomach/digestion/immune compromise. Autism has been linked to immunity disorders, as is,chrones and other “digestive” disorders, which, if one watches tv, seem have lots of ads for treatments of same. Immunity begins in the gut, and if vaccines negatively impact this part of our bodies, autism is the least of our concerns.
6. Which brings me to the fact that there aren’t long term safety or effectiveness studies. This compounded by the fact that any study by the makers (fda doesn’t do research, just passes on what others did.) that doesn’t achieve the desired outcome gets memory holed, never to see the light of day.

So, citizens are left with either believing inept government agencies, and the profit seeking vax makers, or not. Doesn’t help medical,pros just parrot what they’ve been told by vax marketers in. 5 minute “edumarketing appointment” conveniently held,by the people selling the damn things.

My personal experience is that when my youngest was born, they wanted to do vit. K and a hep b vaccine right then, I mean 5 minutes after. Fortunately I asked questions ahead of time. I told them no thanks. Wife had hep b test (part of prenatal exams) and we weren’t circumcising until 8th day per God, so no need to vit k. Interestingly doc doing circumcism didn’t know that on the 8th day, blood clotting factors are highest that they will ever be (I never knew this before looking into it and why circumcise on 8th day.) how can someone who,does this not,know the details? What else do,these pros not know?

Finally, I appreciate your writings - your directness is refreshing. Your Ebola postings are downright scary in their potential to predict that inept path our selfless leadership will most likely follow if given a choice. Thanks,

Aesop said...

1)Vaccines wiped out smallpox, in my lifetime.
One of the most horrible killers of man for centuries, gone.
Unless you'd like to return to the lovely world before modern medicine (and trust me, you don't) you have two choices, then:
a) let someone make them for a profit.
b) Trust the government to make them, with taxpayer dollars.

2) Blanket immunity is the result of predatory lawsuits. Limit damages to actual damages plus legal costs, and we can talk.
When you put the ATLA out of business, we can drop blanket immunity.

3) Autism and vaccines go together like peanut butter and dogshit: not at all.
There is no link between the two whatsoever, and junk science is all that's ever offered in reply. When the spokesperson leading the charge is Dr. Jenny McCarthy, you have your answer.

4) Having said that, every medication absolutely has contra-indications, one of them being allergic reax to the components. File this under "Duh."

5) We don't vaccinate too much. What we do, is slam too many to closely together, because of whiny bitchy helicopter parents. Spread junior's vaccinations out, so there's no risk of combination reactions. He's going to piss and whine and cry about getting a shot until he's 15 anyways, so who gives a fuck. Raise him right, and teach them to get over that shit. Life isn't fair. When you're 18, we can listen to your decisions about health care.

6) That said, moms & dads should be consumers of health care, and do their due diligence. And not sue every time bad things happen.
I'm fine with suits for actual torts caused by negligence of malicious action.
lawsuits for "shit happens" incidents, or times when they told you their were chances of complications, should be treated like lawsuits about losing your ass at the roulette table.
Nobody held a gun to your head, and you took the chance?
Fuck you.
Filed a lawsuit anyways?
mandatory minimum of six months shoveling hot tar in the summer and snow in the winter, and $10,000 fine for contempt of court, and your lawyer gets a year plus a five year license suspension for taking the case.
Second offense for either is a felony.
And prior offenses from any state count in all states.
Next problem.

7)Long-term safety and effectiveness studies?
you mean like the disappearance of smallpox?
Wiping out polio?
The virtual disappearance of rubella, chicken pox, mumps, etc., except among the unvaccinated (esp. foreign-born, illegal alien kids, etc.), and the children of anti-vaxxers?
Testing is only done on adults anyways, because it's completely unethical, in a Dr. Mengele way, to test things on minors. So you're left with anecdotal evidence and empirical data.
Suck it up.

It's simple: you can have 21st century medicine, or 17th century medicine.
But it's one or the other. You can't pick the former, and then pitch a fit when it isn't 100% effective, and 100% harm-free.
Nothing ever made is 100% effective, nor 100% safe, for everyone.
Educate yourself, and make your choices.
Live with the consequences either way.
I don't care which one you choose.
We call that "liberty".

Aesop said...

But the school board has both the right and duty to all the other kids, to tell you that junior can stay home and be ignorant if he doesn't have his shots.
You'd be homeschooling kids anyways if you were as concerned about what they pump into Johnny's head as you are about what they pump into Johnny's arm.

I have a problem with aborted children, period.
I can't tell you when life begins, nor can any scientist.
I can tell you a completely unique DNA "fingerprint" is formed the minute sperm hits egg, and that's the blueprint for the baby that results, from that moment onwards. So calling fetuses "our bodies" is an outright lie; they are their bodies.
Religious scriptures point both ways on the issue, so I don't need anyone to attempt to bring God in on their side either way; it's a "no sale."
But logically, ethically, and morally, since no one knows when life begins, the only correct choice is to err on the side of caution with abortions. And not do them.
The legal and moral proscription against them dates back only at least 2500 years, i.e. the dawn of medicine.
Period, end of discussion.

If someone wants to try and squeak "rape, incest, mother's life in danger", that's fine, and also <1% of abortions, ever. If anyone claims rape or incest, I want you to have to provide the police report, and the case number of the indictment. Any accusations recanted or found to be false get the same sentence as that the accused would have received. For life of the mother in danger, find three unrelated and unacquainted doctors to certify it, and you're on your way. Anybody else should start picking out baby clothes. Condoms are cheap, and the Pill is everywhere. You could also learn to close your legs, for novelty's sake, instead of using abortion as birth control.

Consequently, I regard using the "products of conception" from abortions in the same regard as making lampshades out of Jewish concentration camp victims: there should be a rope and a scaffold waiting for that.

Beyond all that, the testing regimen for the current Ebola vaccine was abbreviated, by mutual consent, for ethical reasons, i.e. it's not ethical to give people in a hot zone of active outbreak a fake vaccination, and let them die, if the actual stuff seems to work, just to fill blocks on a study questionnaire.
It has side effects, but they appear, in the short-term, to be minor.
Because there's no control unvaccinated group, we only know it seem to work but we cannot quantify whether it's 2%, 20%, 50%, 90% or 99% effective.
It's also not approved for use except in emergencies, like the current outbreak.
Science and ethics often clash. It's not ethical to do a double-blind study with control groups when people are dying, and an outbreak is threatening to burn down a continent of 1.2B people.

Get over it.
The fact that they've found one at all that seems to work so far is a minor miracle.
In time, they should refine and perfect the vaccine being issued on a temporary emergency basis, and do what testing they can.

But if they can do to Ebola what we've done to polio and smallpox, that would be a great advance for civilization.

Angantyr said...

Question: how has Africa managed to avoid being totally roto-rootered by Ebola? Given that these borderline (or outright) mental retards actually go out of their way to handle infected corpses, eat bushmeat, fail to practice even the most basic hygiene, etc., I find it mystifying that Ebola has failed to produce infection rates beyond mere tens of thousands. Far cry from the Black Death that wiped out 1/3 to 2/3 of Europe's population in the Middle Ages.

Aesop said...

1) They're dirt poor. That means mostly, they walk everywhere.
2) The disease wipes out everyone within walking distance.
3) Outbreak solved.

That was the pattern for almost every outbreak until 2014.

In 2014, when it got to major cities, it probably killed 50-60K people.
As I've covered fifty times, the official tally is just so much horsecrap.

The guy who got here on an airliner was an outlier, and it still rogered the city of Dallas for two months.
If he'd managed to infect 2-5 family members, we'd have been out of BL-IV beds to hip the problem to, every hospital in Dallas would have been Texas Health, and Texas itself would have been Liberia.
Just the one patient infected two people, which generated hundreds to several thousand contacts in 21 days. We were fortunate to stop the second wave at just two.

If the current outbreak continues as is likely, the biggest risks are
a) it gets across a border; now you've gut multiple outbreaks
b) it gets to a major mega-city; now you have a wildfire in a gasoline refinery
c) someone infected gets to an airport; now you're transplanting it across continents and oceans in hours, not months

If we get to C, Africa could get erased.
So could any other continent.

Fun times.

Angantyr said...

I'll say - thanks for the info.

I should have known better than to take the "official" death tally at face value - my bad. With that death toll, what was the actual number of infections? 100K-150K?

Aesop said...

They acknowledge 17K survivors, and it usually runs a survivor rate of +/- 20%.
Giving them that, there were approx. 85K people infected, which is 17 + 4 X 17K.

If the survival rate was lower, they may have had as many as 170K infected, and over 150K dead.

No one will ever know for sure.
Reliable firsthand accounts are that entire villages in the bush simply disappeared, and reports had people infected simply walking into the jungle to die, uncounted.

It was medieval.

Anonymous said...

My nieces were amongst a group of students who returned to a first world nation after being exposed to Swine Flu back when everyone was panicking about it. They were ordered to stay in their homes for one week (maybe it was two?) until they were given the all clear by the authorities. Anyway a couple of the students broke the mandatory isolation and attended their sporting functions (but of course they didn't go to school).

I was beside myself with rage.

So short version. Well educated, upper class whites in a largely homogenous society (not any more but it was back then) DGAF and broke quarantine restrictions. There is no way that a immivader isn't going to do the same. Heck, you're flat out knowing they're in the country let alone in the country with a contagious disease.

FWIW I've got enough calories for my immediate family for one year.

lineman said...

That's why I chose an area with an abundance of water so that's one area I don't have to worry about...My offer still stands...

The Gray Man said...

I read through the quote you posted, and I'll just say this real quick before reading the rest:

Whoever posted that must not watch people's behavior in town during flu season.

Also, do your drug seekers really ask for Norco? Our drug seekers act highly insulted by even the slightest mention of ONLY receiving a Norco. Sucks to be them though. Our docs LOVE giving IM Toradol and... A handshake goodbye. Get bent, seekers.