A cautionary tale available right now on Netflix.
I’d have given you a trailer but all Youtube has is this truncated snippet showing us Patient Zero in a Chinese elevator.
Regardless, you need to hunt down this movie. It’s a dramatization of how the SARS outbreak in Toronto in 2003 spun out of control, despite the model Canadian healthcare system that was used as one of the main exemplars of what ObamaCare would do for Americans. Government firmly in control of all healthcare resources and costs, guided by the implacable wisdom of the most expert minds available. It was a disaster, so bad that the World Health Organization ultimately closed down air flights to Toronto.
The economic activity of the city was down 30 percent or so for weeks. (Canadians carp about depiction of empty Toronto streets, but they would.) The microbiologist in charge was publicly given all the resources of the province including the full support of the provincial lab. But all but one of the lab staffers had already been laid off years before. Then nobody bothered to communicate with the microbiologist in charge of identifying causes and cures. Couldn’t get access to patient records and the course of their disease. Big government bureaucracy. How they got so deep into the weeds with the WHO.
The brunt was taken by the first Toronto hospital to receive a SARS patient. The doctors were in denial that rapid death from pneumonia was a new disease. The first line medical care personnel didn’t have the appropriate physical protections against the growing numbers of infected. And the social services personnel who were charged with monitoring people who’d had contact with the infected who left the hospital undiagnosed had too few resources to do their job. Meanwhile, the ministry in charge was more concerned with reassuring the public than alerting them of the danger or extending their efforts in support of the medical response. (Maybe why the streets of Toronto weren’t as empty as the movie showed.)
More than 400 SARS patients died, the highest toll paid by medical workers, more than 40 of whom died of the disease.
SARS had about a 10 percent mortality. Ebola has a 60-90 percent mortality.
Why Americans are concerned. The president just played his 200th round of golf this weekend. The Democrats are seizing on the public’s fears to blame Ebola on phantom budget cuts. And the CDC, under the auspices of NIH, are also willing to politicize the issue. Read this:
Liberals’ new message: You know who is responsible for Ebola outbreak in America? Conservatives.
No, really. READ it.
Then you should listen to a doctor who has this thumbnail resume:
Jane M. Orient obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She is currently president of Doctors for Disaster Preparedness.
Here is what she has to say:
U.S. prepared for Ebola – 10 patients at a time
Have you wondered why Ebola patients are being sent to Omaha, Nebraska?
It’s because one physician, Dr. Philip Smith, had the foresight to set up the Nebraska Biocontainment Patient Care Unit after the 9/11 attacks as a bulwark against bioterrorism. Empty for more than a decade, used only for drills, it was called “Maurer’s Folly,” for Harold Maurer, former chancellor of the University of Nebraska Medical Center.
The unit has a special air handling system to keep germs from escaping from patient rooms, and a steam sterilizer for scrubs and equipment.
It could handle at most 10 patients at a time, but one or two would be more comfortable, owing to the large volume of infectious waste.
It is the largest of only four such units in the U.S., and the only one designated for the general public.
Some say this is “overkill” – that our medical workers can be kept safe with much less stringent precautions. Ebola is “hard to get.” It is being compared to AIDS, which has not proved to be a significant threat to medical workers, not even surgeons.
“The Ebola outbreak is presenting some of the same challenges we saw with HIV,” writes Cheryl Clark for HealthLeaders Media, such as “fear of contagion.”
“In many ways, the AIDS epidemic in the early 1980s was the best thing to happen to healthcare,” she claims. For one thing, it brought “universal precautions.”
CDC Director Dr. Tom Frieden also likens Ebola to AIDS. “In the 30 years I’ve been working in public health, the only thing like this has been AIDS,” he said at a World Bank and International Monetary Fund annual meeting in Washington, D.C. “And we have to work now so that this is not the world’s next AIDS.”
Ebola, however, has far greater disaster potential than AIDS. Here are six major differences:
• Universal precautions are mostly adequate for AIDS, which really does seem to be “hard to get.” But despite protective gear, hundreds of nurses and doctors have become infected with Ebola and died in Africa – and so far one is infected in Spain.
• AIDS, at least in the U.S., can be almost completely avoided by refraining from certain behaviors: needle sharing, and intimate contact with men who have sex with men (and with their contacts). But Ebola is an equal opportunity infection.
• AIDS impairs the immune system, so people eventually die of infections that a normal immune system would fight off – but that can often be treated successfully. AIDS does not attack body organs and blood vessels directly.
• Ebola attacks the immune system first, then many other organs and the blood vessels supplying them, leading to rapid death in up to 90 percent of cases. Past a certain point, the damage is irreversible, even if further viral proliferation could be stopped.
• AIDS has never had an explosive outbreak like Ebola’s, which appears to be doubling every three weeks.
• AIDS would not be a suitable pathogen for biological warfare; it is not contagious enough, and it does not kill rapidly. Ebola has been viewed as an excellent biological weapon and researched extensively for this purpose.
Both AIDS and Ebola are zoonotic diseases – diseases that long existed in wild animals and “spilled over” into the human population in Africa. AIDS has no known nonhuman reservoir in North America.
Ebola appears to be capable of infecting dogs and pigs without sickening the animals. This is why the dog in Spain had to be put down when its owner, a nursing assistant, became infected while caring for a patient.
Reassurances from the CDC, and the public policy based on them, rely on assumptions that are probably not true. The CDC still insists that the virus is not “airborne” – at least not for more than three feet. Barack Obama has said that “you cannot get it through casual contact like sitting next to someone on a bus.” But the CDC has told travelers who exhibit Ebola-like symptoms to avoid public transportation.
Our robust and sophisticated medical and public health infrastructure is supposed to be able to handle the situation. Like it did in Dallas? The Dallas public health department is supposed to be carefully following only about 18 – how many more does it have the resources to track? It was not following the caregiver who is now infected – she was self-monitoring.
The CDC says she must have “breached protocol” though it hasn’t said how.
If we have more than 10 or so patients, they can’t be treated in the biosafety-level 4 (BSL-4) facilities that the World Health Organization recommends for this pathogen. They’ll be in places like Texas Health Presbyterian Dallas.
Which is a lot like the Toronto hospital in the movie cited above.
Not inciting panic. Urging education and thought.
P.S. An interesting medical goof in the movie. The nurse heroine, Kari Matchett, flees the deathbed of another nurse, removes the hazmat headgear we’ve seen for the first time in use at the hospital, and collapses in grief with her hands over her face. She still has her possibly infected gloves on. Why interesting? Because when our remote CDC chief tells us of a suspected “breach of protocol,” early rumors were that this was exactly the cause of the current nurse infection, hand to the face. Hmmmm.
Well, maybe. An oddly humdrum addendum. Years ago, had a friend with a germ fetish. He pointed out during a period when fast food workers at mall food courts were all wearing clear plastic gloves that the food preparers tended to think the gloves were there to protect their hands, not the customers, and thus itched and picked as usual at themselves. This is clearly a related case, the gloves being intended to protect both patient and healthcare worker. The gloves aren’t the whole answer. Rigorous training until the counterintuitive requirement becomes second nature is. We can’t just add outfits and checklists and seminars to existing hospital procedures.
Ebola and its like doesn’t come to the emergency room every day, week, or month. Average small town or even community service city hospitals will never be able to ramp up to handle such crises routinely. It would be like training every beat cop to defuse terrorist bombs. Not going to happen. After all the necessary drilling and practicing, they’d have no time left to remain proficient at the tasks that make up 99 percent of their jobs. It’s nonsense.
Enjoy this video from Pennsylvania’s Zombie Senator, Robert Casey, Jr., who thinks such problems can be solved by more money and directives to local hospitals, if Republicans weren’t such skinflints.
His is just another federal money grab on the back of a crisis the Feds are evidently wholly unprepared to meet. Why it’s already become a matter of vicious partisan politics.
Are you disgusted yet?