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    Thread: Had a thought -- a frightening one -- about the Ebola outbreak

    1. #1
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      Had a thought -- a frightening one -- about the Ebola outbreak

      Came across Rick Wilson's little Twitter story from last July -- beware, there is some coarse language in it -- and was kind of amazed he predicted the current outbreak so well.

      It occurred to me the story could use some updating, given what has happened so far. I used his story as a foundation, changed a few things about it, brought the known facts into it, and made my own predictions. This is the result.

      ---

      A (Revised) Thought Experiment

      Tomorrow, or perhaps next week, someone will get on a plane in Cleveland. He hasn’t been contacted by CDC because he’s been out of town. This man was on the Frontier flight from Dallas to Cleveland on October 9. This man, a businessmen traveling to three U.S. cities to various corporate locations, has no outward signs of Ebola and he has no reason to think his nagging sore throat and a headache are anything but a cold or maybe the flu. Come to think of it, is he feeling the effects of a low-grade fever, too? Got to be the flu. Supposed to be bad this winter.

      Headache? Has to be the pressures of the trip. Always is. He hates this part of the job, but it’s necessary. Still, he can’t shake the feeling he isn’t at his best when he gets in a cab in Kansas City. Wow, the crowds are infuriating. Leave it to him to schedule this trip during the first World Series in Kansas City in 29 years! He checks into his hotel, and rests. He wakes up, the headache worse, the cough and fever a definite factor. He fights through the day, feeling worse as it goes along. That afternoon, he gets on a plane to Phoenix.

      Again, getting into the cab, he notes how he feels, and that can best be described as “lousy.” Checks into another hotel, manages to drag himself downstairs to the restaurant to eat, coughing and feeling achy the entire evening. Then he drags himself back upstairs to bed. Next morning, the sun shining through the narrow slit in his hotel curtains is blinding and painful. He walks into the bathroom and promptly throws up. But he's got meetings today. He swallows a handful of Tylenol and stands in the shower until his head clears a little.

      His day goes downhill, with the headache roaring back. At lunch the businessman excuses himself, racing to the bathroom to vomit. By late afternoon, he's feverish, racked with pain in his back. His guts are like liquid fire. He’s seen Fox News, he’s heard about Vinson, but they keep talking about the Cleveland-to-Dallas return flight for her. He has no reason whatsoever to think about being on a plane flying with her into Cleveland. Even if he did, she wasn’t contagious going into Cleveland. Was she?

      He Googles for the nearest walk-in clinic, takes a cab there and is still trying to get work done while he sits for two hours in the crowded waiting room. The sudden spike in his fever hits, and he vomits without warning, this time on the lap of his fellow waiting room patient. He's shocked. It's ... bloody.

      The woman shrieks, grabs her ear-infected kid and drags him with her into the bathroom, panicking. If she knew what was happening, she’d know she was not panicking enough. Now, the Doc-In-A-Box staff knows this guy is sick. They hustle him back, helping to clean him up. Gloves, but no masks at this point. After all, this guy isn’t Thomas Eric Duncan. He didn’t come here from Liberia. For goodness sake, he’s from Cleveland! No one in the clinic stops to think that’s where Vinson was about 10 days ago.

      The patient is having trouble making himself understood the fever is so high. But hey, it's gonna be a pretty bad flu season, and this guy just has the bad luck to be an early victim ... that’s gotta be it.

      The doc, a graduate of a decent medical school in the Midwest and an internal medicine specialist hired by the hospital that owns this walk-in, rolls in after the two nurses have cleaned him a bit and takes his vitals. There's an important moment happening out in the waiting room. Ear-infection mom and her toddler? Tired of waiting. They've gone home to change clothes before going to the corner mega-drug store that also has a walk-in.

      ---

      See Post #2)

    2. #2
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      The doc doesn't see a lot of cases like this. Ever, in fact. He walks out of the room, unconsciously shoving his gloves into his pocket. Now, there are a whole bunch of CDC and DHS rules about early identification of outbreaks, and the reporting of same. But ninety percent of his cases are sprains, trivial cuts, kids with ear infections, flu shots. This can’t be anything irregular. No way. Ebola would not stroll into a walk-in clinic in Phoenix. Would it?

      This guy is spiking 103, is in distress. Obviously the flu, a very bad case. Doc walks out, washes his hands, and decides to make the call ... right after he looks at little Johnny's split lip, a local carpenter’s deeply imbedded wood sliver, and telling Mrs. Gomez antibiotics don't help the common cold but prescribing one anyway. He's dialing the phone when he hears loud, distressed shouts. The patient is standing in the hall, bloody diarrhea running down his pants leg. It's a mess, and he’s obviously getting delirious. His two nurses and one orderly are trying to help get the patient in hand. Doc hangs up in mid-dial and hits the speed button for 911.

      The nurses and orderly are scrubbing down. The floor is an unspeakable horror of watery feces and blood. A departing patient skirts the visible muck, but maybe not entirely. Midafternoon traffic is a horror, and the ambulance takes 24 minutes to arrive. The patient is quiet again, whispering for water. The EMT's know something is off about this one. One had spent time in Africa with Samaritan’s Purse. But even he doesn’t automatically think "Ebola." And no one mentions the bloody mess they just cleaned up.

      Banner Samaritan's ER procedures are a lot better. But just before Business Guy’s ambulance pulls up into the ER bay, another ambulance rushes a gunshot victim into the hospital. Probably a drug deal gone bad, thinks the doc on duty. Happens around here a lot. That ambulance crew that radioed in about a severely ill flu patient? They’re just going have to drop him off and let him wait.

      Meanwhile, the hotel maid enters room 618, currently housing the luggage – and dirty clothes – of our vomiting, feverish businessman. She's disgusted he’d leave such a mess behind in the bathroom, but begins to clean it up. She's got on Playtex gloves, but she stops to wipe her brow ...

      The doc at the walk-in surveys the mess of his day, and the cleanup continues, He fleetingly remembers the CDC disease reporting rules. But it was just flu, and the guys at Samaritan will report it if it’s serious. Won’t they?

      Meanwhile, our traveling businessman is on a gurney, on fluids. He's hallucinating and fever-shouting. He rolls his head to the side, and vomits out what looks to be mostly blood. It shocks the ER staff. Not exactly what they’re used to. They're careful, thinking “blood-borne pathogens,” because … well, because it's blood. But they're really scared when they notice … it's ... chunky, and not like when someone throws up lunch, either.

      They ask one of the attendings working on the gunshot victim what to do. He takes a peak out through the curtain and goes pale. He shouts, “Get that patient into isolation, stat.” Nurses don masks and gloves, and roll him into an isolation room. The doc tells his colleagues they will have to work the gunshot themselves. He follows the gurney with Business Guy on it down the hall to the isolation room. But it's not hermetic, negative internal pressure. It’s just a room, and when the door opens, the outside air and the inside air become mixed …

      ---

      See Post #3

    3. #3
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      They get blood panels running. No one has said the word, "Ebola." But now there's a weird feeling in the air. This isn't typical ER work. They haven’t seen Ebola before, but they’ve all read the CDC bulletins over the last two weeks, and this is all seemingly very familiar. Two more doctors are called downstairs from internal medicine, and at a break, one of them says, "How do we report a suspected infectious disease again? Isn't there a website?"

      One of the ER docs has training on the CDC's NORS system, but it's his day off. They ask around, and eventually hospital legal gets wind of it. The administrator and the hospital’s general counsel both agree: "Wait for blood work to come back in first. No need to start a panic. Don't want our ACA score dinged." So Patient X is in isolation, feverish, given fluids, plenty of care. A very nervous, bordering on frightened staff, gets a virologist/epidemiologist consult ordered in.

      The virologist hears the business guy’s symptoms over the phone, but the staff doesn't go into detail. When he arrives and gets briefed, he too turns pale and says, “You called CDC, right?” Blank stares. “Uh … “ He calls CDC, tries to find the right person. Too late in the day. He leaves a message. Calls back. Leaves another one on someone else’s voicemail. Calls a third time. Voicemail again. Gives up.

      Because it doesn't work like the movies. There's not perfect knowledge. There isn’t constant vigilance. There is no instant communications in or out of government. It's always a mess. It's always chaotic. All those CDC/HHS/DHS plans? No one has read them. No one is ready. To the virologist’s credit, he orders the staff to gown up completely, infectious disease precautions in effect, and asks about the availability of the hermetically sealed isolation room upstairs.

      Now, let's get to the fun part. In the course of the last two days, there are probably a couple hundred people directly exposed to Business Guy. Some of them go home, work and school. Some of them in Kansas City go to the World Series. Some of them in Phoenix go to the Cardinals-Eagles football game the following Sunday. All of them feel fine for a few days before they start feeling lousy.

      Maybe they were contagious at the baseball and football games, at home, work and school, but maybe they weren’t. For sure they all were contagious later – at the office, at school, at home, at other events. Some of those in Kansas City were Giants fans, and went back home for games three through five, and a lot of Kansas City fans followed them. Some of those at the Cards-Eagles game were from Philly. Some won't come down with a thing. But it is a good bet that half of them will: And remember, this isn't the movies. The CDC isn't SEAL TEAM EBOLA.

      A few days later, the unlucky are starting to feel like hell. But ear-infection mom isn't going to cancel that trip to Disney for anything. The orderly? He and his girlfriend are trying to get pregnant. The maid? Family reunion. The walk-in doc? Going to Chicago to see mom. Nurses and ER docs? Parties, family gatherings, etc. Baseball and football fans? They work, go to school, have families too. Overlooked in their busy lives is the fact that Business Guy dies 24 hours after entering Samaritan.

      Around the same time, the CDC confirms he died of the strain known as Ebola Zaire, same clade – “germ family” – as is currently infecting West Africa, same clade that killed Duncan, same clade that infected nurses Pham and Vinson. CDC is getting tired of being a scapegoat for the Ebola outbreak, so they don’t tell Samaritan that Business Guy had Ebola. In other words, they lie. CDC does tell HHS, and someone there tells DHS, and someone there finally tells the White House Chief of Staff.

      ---

      See Post #4

    4. #4
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      This is happening In the United States! Can't panic folks, start a stampede, right? Gotta keep the market running, the dollars flowing, the public stupid, right? And CDC bragged early on “we’ll stop it in its tracks.” Can’t admit they failed, now can they? Even though they looked like a bunch of idiots before the House Energy and Commerce Subcommittee on Oversight and Investigations. Can’t have that kind of bad media exposure again, can we?

      The White House privately asks CDC to confirm the results. CDC steps up its game and tries to walk back Patient X's timeline, trying to isolate contacts. But it's getting late in the game. And how the heck are people who were within a few feet of Patient X when he coughed sputum all over the restaurant supposed to recognize him from that poor quality family photo this lady who says she’s from some government agency shows them? If she even talked to the right people to begin with. She found a lot of people who were on the airplanes with him, as did her colleagues. But how was she going to find the right restaurant customers at downtown hotels in Kansas City during the World Series, or Phoenix just as the snowbirds are arriving?

      Life isn't a movie. The CDC finds thirty-two of the contacts. Just thirty-two. The rest? Who knows where they are? Reality leaks downhill. The governors of Missouri and Arizona find out, and are immediately livid they were kept in the dark over CDC teams in both states looking for freakin’ Ebola, for cryin’ out loud! It was a mistake, staff members in both states say. These trusted assistants were told by CDC “it’s just an exercise.”

      That's the rule: Everything is chaotic. No plan survives contact with reality. Government agencies have bad communications. Within themselves. With each other. With the public. Life. Is. Not. A. Movie!

      It breaks, right around Day Four after Business Guy died. A web bulletin on The Kansas City Star website goes viral within minutes. Fox News Channel puts up nonstop coverage, and the other media outlets are pretty much forced to join in, despite the bad light it casts on their president. Twitter's #Ebola tag trends, and doesn't stop. Rumors fly. Republicans blame Obama. Democrats deny that Ebola exists, and if it does, it was made by the Koch brothers, and racism.

      Everybody blames everybody. No one takes responsibility. Because every damn thing is political. Every damn political thing has consequences. No one wants to be left holding the bag of consequences.

      Media flood Kansas City and Phoenix, reporting in full Racal suits, at least before the cameras. Too darned hot to wear those things when not on-air, and it messes up the pretty lady reporters’ hair. But they do mix with hospital staff and "witnesses" off-camera, out of their inconvenient suits. Rumors fly like mad. The markets crap the bed, and keep doing so. It’s going to make the 2008 housing collapse and subsequent bear market look like a “temporary market correction.” The Fed steps in. Doesn’t help.

      The Dow plunges below 8,000, losing fifty percent of its value in less than a month. World markets match the panic and the reality of a worldwide depression never before matched in history begins to take hold of investment houses, stock exchanges and banks. Bank runs, closings and panics are unprecedented. Businesses close, both out of fear of Ebola and out of financial disaster. Sometimes both. Suicides and murders in the business executive offices around the world eclipse the number of Ebola deaths five-fold in three days.

      Social media and email are flooded with Ebola spam. "The one weird trick to stop hemorrhagic fevers!" Meanwhile, our second-tier infected start dying, including a great number of people CDC never interviewed, never saw, never even had their names. They infect another tranche of health care workers, doctors, EMTs, family members, co-workers, classmates, strangers on the taxis, subways, trains and planes all over the U.S. They in turn infect still more of those with whom they come in contact, even though everyone everywhere is far more aware of Ebola symptoms, even when they don’t have Ebola.

      ---

      See Post #5

    5. #5
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      Hotel workers, orderlies, cleaning staff, and others don't go to the docs. Some because of their fear of ICE, some due to lack of health coverage – and thanks to Obamacare, there are now millions more of those than there were three years ago. Such people tend to live in multigenerational, multifamily, close-contact environments with internal social cohesion. Outsiders? No bueno.

      There comes a moment about a week after the story breaks when the media coverage is truly terrifying. Not that it wasn’t frightening enough to begin with. The clusters in Kansas City, San Francisco, and Phoenix are spreading outward from those population centers. St. Louis, Tucson, Sacramento are next. Then new clusters seemingly pop up out of nowhere: Atlanta, Denver, Detroit, Miami, New York City and Chicago. After over 5,000 people die, the White House decides something drastic must be done – unlike the beginning, when Pham and Vinson first got sick, when the attitude was “We got this. Don’t worry.”

      Guess what? They didn’t “have this.” Everyone should worry. Especially now that people are dying all over the country.

      Obama decides his new “Ebola czar” Ron Klain – only on the job for two weeks – can’t get the job done by himself. Obama declares martial law. He grounds both domestic and incoming international flights. He essentially quarantines everyone to their houses and a surrounding ten-block area, with exceptions for buying groceries and other essentials, but the National Guard will monitor each store to keep more than 25 people at a time from entering.

      Hospitals must isolate and report every single patient walking in with symptoms that even remotely resemble Ebola. He orders experimental vaccines not yet proven through FDA testing to either be effective nor to be free from side effects mass produced and distributed throughout the country, not just for the already sick, but for the possibly exposed as well.

      He cancels the November 4 elections. Can’t have people mingling from all over a given precinct and spreading germs everywhere, can we? Congress is told they will not reconvene for a “lame duck” session after the now-canceled elections. Obama says he can handle the government from Washington. Everybody just sit tight until he decides it’s safe to move again.

      ---

      OK, we can all breathe again. This is fiction. It isn’t really happening. Is it?

    6. #6
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      Didn't read it - way toooo long

    7. #7
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      Quote Originally Posted by SALTY View Post
      Didn't read it - way toooo long
      I tried telling the story in a paragraph. Didn't work.

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