On Monday afternoon AlertsUSA subscribers were notified via text messages to their mobile devices regarding new CDC warnings issued to hospitals, clinics, doctors, infectious disease specialists and other medical professionals nationwide regarding the West Africa Ebola outbreak and the need to prepare, NOW, for the eventual arrival of cases in the U.S..
Specifically, the CDC has issued a 6-page checklist (SEE THIS (PDF)) to U.S. medical facilities and personnel providing specific suggestions to ensure hospitals are able to detect Ebola cases, protect employees, and respond appropriately. The CDC warns that “now is the time to prepare, as it is possible that individuals with EVD in West Africa may travel to the United States, exhibit signs and symptoms of EVD, and present to facilities.“
Conflicting CDC Information
The CDC document clearly states “we are not aware of any domestic EVD cases (other than two American citizens who were medically evacuated to the United States).” Really? This would appear to directly contradict AlertsUSA-verified reports of other EVD cases transported to the U.S.. In addition to the two original American missionaries treated in the U.S. in August, a third is currently being treated at Nebraska Medical Center in Omaha (SEE THIS) and another new case at Emory University Hospital in Atlanta. (SEE THIS).
Further, the CDC statement also directly contradicts information provided by an executive of Phoenix Air Group, the specialized medical air transport company contracted by the State Department to carry out the highly publicized Ebola evacuation flights.
As reported in the last issue of Threat Journal (SEE THIS), Dent Thompson, Vice President of Phoenix Air Group:
“We moved a lot of other people who had an exposure event.“
Thompson states that medical privacy laws and his company’s contract with the State Department prevent him from revealing the actual number of Ebola patients transported, though he does indicate that Phoenix Air has flown 10 Ebola-related missions in the past six weeks.
On July 31, 2014, President Obama signed an amendment to Executive Order #13295 expanding the list of quarantinable communicable diseases to include severe acute respiratory syndromes, “which are capable of being transmitted from person to person, and that either are causing, or have the potential to cause, a pandemic, or, upon infection, are highly likely to cause mortality or serious morbidity..” if not properly controlled. This subsection does not apply to influenza.”
On August 6, 2014, the Centers for Disease Control placed their Emergency Operations Center its highest activation level (Level 1), an action it last took during the 2009 H1N1 influenza pandemic.
On August 7, 2014, Dr. Thomas Frieden, Director of the Centers for Disease Control, stated that the arrival of Ebola in the U.S. is inevitable. “That’s primarily because we are all connected and inevitably there will be travelers, American citizens and others who go from these three countries — or from Lagos if it doesn’t get it under control — and are here with symptoms.”
On August 25, 2014, the Centers for Disease Control issued guidance to all U.S. hospitals and mortuaries on the safe handling of human remains of Ebola patients.
On August 28, 2014, the U.S. State Department issued a warning for American citizens traveling abroad that they may be subject to increased screening procedures, travel restrictions, forced quarantine and reduced transportation options in response to the Ebola outbreak.
On September 8, 2014, the World Health Organization warned that new Ebola infections are increasing at an exponential rate and many thousands of new cases are expected this month in Liberia alone.
On September 8, 2014, the DHS Office of the Inspector General made public a report stating that DHS is “ill-prepared” to handle a nationwide pandemic.
On September 12, 2014, Dr. Margaret Chan, Director General of the World Health Organization, stated that Ebola virus cases in West Africa are rising faster than the ability to contain them.
On September 14, 2014, President Obama described the outbreak as a national security threat to the United States and has authorized the deployment of U.S. military forces to the region to assist in the setting up field hospitals and isolation units, to provide protection for medical staff as well as other tasks in an effort to help in the overall international response.
FLU SEASON AND EBOLA – THE PERFECT STORM
AlertsUSA cautions readers that flu season is fast approaching. Given that standard flu symptoms such as fever, vomiting, sore throat, coughs, muscle aches, fatigue and headaches are also early symptoms of an Ebola infection, medical facilities in the U.S. and Canada are facing a nightmare scenario.
On one hand, there will be the regular seasonal surge of those suffering from influenza seeking treatment. On the other hand, given that Ebola is one of the most dangerous and virulent pathogens known to exist and the stark similarities in early symptoms to the flu, medical facilities may be forced to take drastic measures with each and every patient, including possible isolation and quarantine, until a laboratory confirms a diagnosis. There are few other options. And as the Director of the CDC stated just last week, Ebola’s arrival in the U.S. is “inevitable.”
It is with the approach of this problem that AlertsUSA fully expects in the coming weeks for federal health authorities to announce activation of a “National Nurse Triage Line” in order to help manage persons with influenza-like illnesses and to electronically or telephonically transfer authorized prescriptions to local pharmacies. Such a capability was actually put in place last year by the Dept. of Health and Human Services over concerns of a possible bird flu pandemic.
With this potential perfect storm of confusion right around the corner, AlertsUSA recommends that readers strongly consider getting both a seasonal influenza and pneumonia vaccination soon. While this will in no way offer protection from a possible Ebola infection, it WILL help increase your chances of not having to approach a medical center in the first place.
Consider Yourself Forewarned: The spread of the Ebola virus is expected to continue for many months to come. As such, the chances are good that during the upcoming flu season, if you present yourself to a hospital or clinic with flu-like symptoms, and in particular, a respiratory infection, you may have a nightmare experience that includes forced quarantine until the staff receives laboratory confirmation of what ails you. This can already be seen in reports from hospitals and airports around the world when individuals show up just running a fever (seethis, this and this).
Additionally, AlertsUSA again strongly recommends that airline travelers and those using public transportation become hyper sensitive about your proximity to those visibly ill during your trips. While health authorities stress that Ebola is not airborne, it is believed to be transmissible, as with most other contagions, via airborne saliva droplets, such as those released in coughs and sneezes.
TAKE NOTE : The CDC now admits that casual contact, meaning anywhere within 3 feet of an infected person, does pose a risk of transmission [Emphasis added ].
“Casual contact is defined as a) being within approximately 3 feet (1 meter) or within the room [or airline cabin] or care area for a prolonged period of time (e.g., healthcare personnel, household members) while not wearing recommended personal protective equipment (i.e., droplet and contact precautions–see Infection Prevention and Control Recommendations); or b) having direct brief contact (e.g., shaking hands) with an EVD case while not wearing recommended personal protective equipment (i.e., droplet and contact precautions–see Infection Prevention and Control Recommendations).”
As such, your increased, polite vigilance can only be a benefit to your overall safety.
GUIDANCE AND RISK MITIGATION
While it is impossible for anyone to be fully prepared for each and every type of emergency, it IS possible to mitigate your risk in specific, known threat environments. This is the case with the threat of Ebola.
The warnings issued by national and international health authorities as well as actions of the federal government should be your clue that it might be time to take some preparedness steps of your own. If nothing happens here in the United States, GREAT! On the other hand, if Ebola cases do begin appearing in the U.S., preparedness efforts will be significantly more challenging, if not impossible, because key items such as surgical gloves, protective masks and related products will be unobtainable.
As such, we STRONGLY encourage readers to take the hint from federal government actions and statements and prepare NOW.
AlertsUSA has established an Ebola preparedness website offing specific guidance and information on how to prepare for and respond to a domestic outbreak of Ebola. http://www.EbolaReady.com .
Many of the preparedness suggestions on this page reflect common sense. Others will come across as cold and severe until it is remembered that Ebola is a highly infectious and deadly pathogen. More than half of those who become infected die and that death is particularly gruesome.
In addition, we make product suggestions on the site with links to a multitude of suppliers via Amazon as they are convenient and inexpensive compared to most retail outlets. That said, if you can find these products elsewhere at a better price, by all means exercise those options. The links are there for your convenience.
For 7 of the past 8 weeks, AlertsUSA and Threat Journal have been warning of the progression of the West Africa Ebola outbreak and the danger posed to the continental United States (See 1,2,3,4,5,6,7). A wealth of information is available within those past issues.
CDC – Case Definition
CDC – Ebola Page
WHO – Ebola Page
CDC – Ebola Guidance for Airlines
CDC – Detailed Hospital Checklist for Ebola Preparedness (PDF)
CDC – Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals
CDC – Safe Management of Patients with Ebola Virus Disease (EVD) in U.S. Hospitals World Health Organization Ebola Page
CDC – Legal Authorities for Isolation and Quarantine
CDC – Specific Laws and Regs Governing the Control of
CDC – Final Rules for Control of Communicable Diseases:
Interstate and Foreign
As always, AlertsUSA continues to closely monitor developments with the spread of this virus and will immediately notify service subscribers of major changes in its spread to different regions, important notices and warnings by government agencies or any other major changes in the overall threat environment as events warrant.