Bengalcat

And who, here, is proposing that Ebola is "airborne"? The authors' main purpose is to address risks to HCWs in close proximity to the patient from aerosolized particles and the implications for optimal respiratory protection. To quote more fully: "Airborne transmission is defined by HICPAC as resulting from the inhalation of small respirable particles that 'remain infective over time and distance' and 'can be dispersed over long distances by air currents' . . . "Aerosol transmission [as defined, herein] recognizes that the spraying of body fluids containing Ebola virus directly onto mucous membranes is unlikely to occur in the absence of inhalation of infectious aerosols. Available data do not indicate that aerosol transmission at a distance from an infected person is an important route of Ebola virus transmission. In this we agree with statements from the CDC that the "airborne" (old paradigm) route of transmission (inhalation of infectious particles at a distance from the source) has not been documented in previous EVD outbreaks. "There are at least two explanations for why Ebola virus transmission has not been shown to occur at a distance from the source, even though data suggest that Ebola virus can remain viable in the air for some time (up to 90 minutes at room temperature and humidity).29 One explanation is that Ebola virus is not viable by the time it gets to point C (ie, inhalation of non-viable virus will not produce an infection). A second possibility is that the infectivity of Ebola virus upon inhalation of small particles is very low, so the probability of infection is too small to observe."

Article: COMMENTARY: Ebola virus transmission via contact and aerosol — a new paradigm. R. M. Jones & L. M. Brosseau. November 18, 21014. CIDRAP. http://www.cidrap.umn.edu/news-perspective/2014/11/commentary-ebola-virus-transmission-contact-and-aerosol-new-paradigm

I don't understand what the source of the confusion is, here. However, to clarify, I never intended, by my statements, to assert that Ebola is airborne--quite the contrary.

Additional explanation provided by CDC: "Recommended Personal Protective Equipment - "PAPR or N95 Respirator . . . o "PAPR: A PAPR with a full face shield, helmet, or headpiece. Any reusable helmet or headpiece must be covered with a single-use (disposable) hood that extends to the shoulders and fully covers the neck and is compatible with the selected PAPR. The facility should follow manufacturer's instructions for decontamination of all reusable components and, based upon those instructions, develop facility protocols that include the designation of responsible personnel who assure that the equipment is appropriately reprocessed and that batteries are fully charged before reuse. "A PAPR with a self-contained filter and blower unit integrated inside the helmet is preferred. "A PAPR with external belt-mounted blower unit requires adjustment of the sequence for donning and doffing, as described below. o "N95 Respirator: Single-use (disposable) N95 respirator in combination with single-use (disposable) surgical hood extending to shoulders and single-use (disposable) full face shield.** If N95 respirators are used instead of PAPRs, careful observation is required to ensure healthcare workers are not inadvertently touching their faces under the face shield during patient care." http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html CDC Video: Respiratory Protection for Ebola: Not sure what you mean by this. Could you kindly clarify?

The book, Hot Zone, and the cited film adaptation, thereof (Outbreak; 1995) was about an airborne virus. The Cal-OSHA rationale for specifying PAPR's is linked with the likely event of HCWs, here, in the U.S. performing high-risk aerosol-generating procedures, which are not performed in field hospitals in Africa. Please also refer to current CDC guidelines in re droplet precautions.

I am not aware of any robust research studies relating to public perception and attitudes on the subject. However, one might be tempted to speculate that the public is better assured by the revised CDC protocols for active monitoring, et al. It, perhaps, bears mentioning that few outside of public health would have known and understood before now the distinctions between the different monitoring protocols, quarantine, and isolation.

It’s foreseeable that we will treat other HCWs, who served in the hot zone and who are not either U.S. citizens/residents or from Europe—and rightly so, in my view—based on transportation or geographical considerations.

I would imagine that the HCWs, who care for Dr. Salia will undergo the post-care monitoring protocols specified by the CDC and State of Nebraska. What would you infer? Of some possible interest--to quote the below-cited CBS News link: "Dr. Martin Salia will be taken to the Nebraska Medical Center in Omaha . . . "The hospital in Omaha is one of four U.S. hospitals with specialized treatment units for people with highly dangerous infectious diseases. It was chosen for the latest patient because workers at units at Atlanta's Emory University Hospital and the National Institutes of Health near Washington are still in a 21-day monitoring period." http://www.cbsnews.com/news/doctor-with-ebola-on-way-to-u-s-called-absolutely-dedicated/

Per the Pentagon memorandum issued 31 October 2014, said DoD civilians will be required to follow one of two medical protocols upon their redeployment from the hot zone—viz. in accordance with their choice, as specified prior to their deployment: 1) Voluntary participation in military-controlled monitoring—a 21-day post-deployment, face-to-face, active monitoring period, which precludes any leave, temporary duty, or temporary additional duty outside the local, isolation area (like the troops); or 2) Active monitoring for 21 days post-deployment, which includes twice-daily temperature checks, plus return to normal activities per CDC, state, and local public health authority protocols “unless otherwise directed”—meaning the military reserves the right to enforce military-controlled monitoring where EVD exposure is suspected. In other words, if the DoD civilian returns to a state, such as New Jersey or Maine, or a local community, which has stricter guidelines than the minimum protocols established by the CDC, the civilian agrees before deployment to abide by those stricter guidelines. Major General Darryl Williams, commander of U.S. Army Africa, and 11 of his staff were placed in 21-day isolation upon returning from the hot zone to their base in Vicenza, Italy, last weekend. According to a statement released the following Monday, 27 October, Army Chief of Staff, General Ray Odierno, ordered the isolation “to reassure the troops, their families, and local communities that the Army is taking all steps necessary to protect their health.” Odierno's order went beyond Pentagon policy, which specified monitoring, not isolation. However, on Tuesday, 28 October, Army General Martin Dempsey, Chairman of the Joint Chiefs of Staff, formally recommended on behalf of the heads of each of the military services the stricter guidelines for all military personnel returning from the hot zone. The military commanders cited numerous reasons for doing so, including concerns among military families and the communities from which troops are deploying for the Ebola response mission. Secretary of Defense, Chuck Hagel, complied with the commanders’ recommendations on Wednesday, 29 October. These stricter guidelines also accord with evidence-based military theory (“Fourth Generation Warfare”), which recognizes that any war fought in the foreign theater (in this case, against Ebola in Africa) cannot be sustained and won, if the war at home is lost—viz. through loss of public support.

Given that some of the more zealous commentators on this list have thrown an infectious disease researcher with a Nobel Prize onto the pile of the scientifically-challenged, that’s a club I don’t mind belonging to.

Please provide supporting evidence for your allegation that I promoted suppression of free speech in the cited post or anywhere else on AN.

And I’m appalled at the rabid disparagement of the America public evinced by a few nurses on this forum. Frankly, I wouldn’t want to be one of your patients. Please try to recall your nursing education that we are public servants, who owe our empathy and respect to those whom you so fervently malign. Seek for solutions, instead of being part of the problem.

This is a very sad day. I had hoped that Ms. Hickox would take the high road. Instead, it can reasonably be expected that her actions and those of her attorneys will further undermine public trust in the Federal government's handling of the Ebola crisis and, consequently, support for relief efforts in Africa. On a more personal note, I fear that her actions will reflect badly on the nursing profession. Trust is hard to gain, but easily lost. As such, I feel compelled to publically condemn her actions.

Passengers on all incoming, international flights are required to present their passports/visas before entering the country. It is irrelevant that there are no direct flights arriving in the U.S. from Sierra Leone, Guinea, and Liberia. That said, it is certainly possible that a relative few could circumvent a travel band, if they had a second passport.

]IAFF Calls for Safety Stand Down for Ebola Preparedness http://www.sconfire.com/2014/10/16/iaff-calls-safety-stand-ebola-preparedness/