Ebola and the CDC: Scourge in the Making

Thomas Eric Duncan will go down in infamy as Patient Zero, the person who brought Ebola to the United States. Nina Pham, a nurse who cared for Mr. Duncan in Dallas, Texas, will go down in history as the first person to be infected with Ebola on U.S. soil. Her co-worker, Amber Vinson, another caregiver to Mr. Duncan, is victim number 2. As of this writing, they are the only U.S. victims so far, but with certainty, more are to come.

Dr. Thomas R. Frieden, whom we can only hope one day in the not-too-distant future will become the former Director of the Centers for Disease Control and Prevention (“CDC”), recently admitted that perhaps the CDC “could have done more” to prevent the unprecedented outbreak of Ebola in the U.S. Among the mistakes that the CDC admits to are:

• Failure to determine that Mr. Duncan had arrived in the U.S. from Liberia and discharging him from his initial ER visit with a simple dose of antibiotics.
• Failure to advise Dallas Emergency Services to screen 911 calls for Ebola.
• Allowing the ambulance that returned Mr. Duncan to the hospital to remain in use for an additional 48 hours.
• Failure to alert Dallas officials that ambulances should be equipped for Ebola calls.
• The absence of a protocol for safely disposing of Mr. Duncan’s bedding, clothing and hospital waste.

Perhaps Dr. Frieden should take a page from the playbook of Julia Pierson, the former Director of the United States Secret Service, who resigned on October 1, 2014, after putting President Obama in more potentially dangerous situations than anyone in that position previously ever allowed to happen to a sitting U.S. Commander in Chief. At least Ms. Pierson had the common sense to resign before her inevitable firing, which was a foregone conclusion. Dr. Frieden under-estimated the Ebola threat, and now it’s only a matter of time before countless people could be stricken by the disease. If only the CDC had acted more responsibly and sooner.

I did some research about Ebola and here’s some of what I found out:

• Ebola was first discovered in 1976 in Yambuku in the Democratic Republic of Congo, a village near the Ebola River, from which the disease takes its name. Anyone for an all-expense-paid cruise down the Ebola River?
• The current outbreak started in March 2014 and is the largest and most complex since 1976. There have been more cases and deaths in this outbreak than all others combined. It started in Guinea, then spread to Sierra Leone, Liberia, Nigeria and Senegal. And now the United States.
• The average fatality rate from Ebola is 50% but ranges from 25% to 90%. The virulent spread of the disease in West Africa has resulted from the sad fact that the most severely affected countries have very weak health systems at best, lacking human and infrastructural resources.
• The incubation period from infection to virus onset is between two and 21 days. Symptoms include the sudden onset of fever, fatigue, muscle pain and sore throat, followed by vomiting, diarrhea, rash, internal bleeding and the list goes on. It’s an out-and-out nightmare (I will resist the sophomoric comparisons).
• There’s currently NO vaccine to prevent Ebola.

To further complicate things, Ms. Vinson (patient #2), who developed a low grade fever late Monday and was confirmed with Ebola Wednesday, took a flight from Cleveland to Dallas Monday night, after advising the CDC of her fever and getting their permission to fly – Frontier Airlines flight 1143, which had 132 passengers plus crew aboard. Dr. Friedan and the CDC have said that the risk to passengers who shared the flight with Ms. Vinson was very low. Based on how they’ve misstepped so far, I can’t seem to find comfort in their assurances.

I hate to be an alarmist, but if the CDC were as concerned as I am, perhaps I’d be writing about something else this week. It seems the CDC forgot part of their job is prevention, not just containment after the fact. We can only pray for a full recovery for those currently stricken and those sure to be in the days to come.