Friday, October 24, 2014

Healthcare Selfishness More Scary than Ebola


When we talk about Ebola, it's not the disease that should scare us.

It's we ourselves who are scary.

You see, Ebola is simply an infectious disease.  And we know how to contain it.  And it's a relatively easy disease to contain.  Although it's quietly been around since 1976, it's dominating our consciousness now because we humans are not doing a good job of containing it.  While science has yet to determine Ebola's precise cause, we know that if everybody eliminates their contact with the bodily fluids of primates who have Ebola, Ebola won't spread.

Humans aren't the only primates who can contract Ebola.  Monkeys, fruit bats, and chimpanzees have been known to carry it, which is why outbreaks of the disease usually begin in tropical climates.  Humans in these tropical climates get it from the bodily fluids of these animals.  But Ebola can be stopped in humans.

Technically, Ebola has been in the United States before now.  Back in 1989, an Ebola strain was found in some monkeys that had been imported from the Philippines, but fortunately, no American ever contracted the deadly fever.  For whatever reason, that particular strain was not harmful to humans.

Unfortunately, that was 1989, and this is 2014.  In March of this year, the World Health Organization recognized that an Ebola outbreak was under way in Guinea, Liberia, and Sierra Leone.  It has become the largest Ebola outbreak in history, starting from the death of a two-year-old child, and claiming, up until the middle of this month, over 4,800 people in Africa.  As of today, four people have died of Ebola outside of Africa, including one African national who died in Dallas on October 8.

As epidemics go, this current wave of Ebola isn't the most catastrophic of human events, but even for people who survive the disease, it can be a harrowing physical and emotional experience.  Perhaps part of the sensationalism of it all, back when it was confined to Africa, was that it seemed to simple to stop, yet it kept spreading.  The problem?  African healthcare workers didn't have the proper training and equipment to protect themselves from all of the bodily fluids Ebola's victims were eliminating through, well, their pores, both of their major orifices, and even their corpses.  It seemed so tragic that people in these three impoverished countries were so helpless when basic, life-saving tools like plastic protective gear are so abundant in the rest of the world.

Or, so we were led to believe.  Flash forward to Dallas, where America's first in-country victim of Ebola went for treatment.  Reportedly, days went by before one of the wealthiest hospitals in Texas procured enough protective equipment for its staff.  And America's premiere center for disease control - called the "Centers for Disease Control" (CDC) - churned out so much conflicting instructional material on how Ebola should be treated, Dallas nurses were told to pick and choose the information they felt comfortable with using.

But the dog-and-pony show that has become America's grand entrance onto the world's Ebola stage didn't end there.

Instead, we've had a doctor - a highly-trained medical professional, no less - return to New York City from Guinea after treating Ebola patients, and what does he do?  He's feeling tired and fatigued, so he rides the subway.  Rides an Uber car (which, if you've been living in a cave recently, is basically a private taxi).  Goes bowling in Brooklyn.  And how he's testing positive for the Big E.

He's supposed to be an altruistic "do no harm" healer, yet, after piously working with Ebola patients half a world away, he integrates back into the largest city on our continent, and takes whatever germs he might have contracted all the way from his large, multi-tenant apartment building in Harlem, in northern Manhattan, to trendy Williamsburg, Brooklyn.

To go bowling.

Granted, after treating medical patients of any kind in almost any country in Africa, it's not surprising for a doctor to feel tired and fatigued upon returning stateside.  Maybe - obviously - he underestimated his symptomology.  But what kind of special intelligence is required to suspect that one's fatigue could be symptomatic of something else... like Ebola, the disease you've just been treating in a Majority World (aka "Third World") country?

Then there was the nurse from Dallas who, after treating America's first Ebola patient, apparently didn't have enough common sense to convince herself that she shouldn't fly to Ohio from Texas - and back - on a commercial airplane.  She asked the CDC if she should, and they said, "sure, go ahead!  We've already botched the whole care scenario for Dallas, so what difference does it make now?"

Is this all merely human error?

Of course, the person who got the whole ball rolling was the guy who lived in an Ebola-terrorized country in Africa who still saw no reason why he shouldn't come to America after helping to care for his landlord's daughter, who had Ebola.  His family here in Dallas insists he didn't do all of the things his neighbors back in Liberia told reporters he did - like helping to carry his landlord's pregnant, Ebola-stricken daughter back and forth from a clinic before she died.  So, how did he get Ebola, then?  He came into contact with the bodily fluids of somebody there with the disease.  He didn't contract Ebola in the United States - nobody here had it before he arrived.

"Compassion," we're told.  Be compassionate, sympathetic, and supportive of these victims.

I'm not going to get Ebola from any of them - I haven't met them, and haven't been near any of them, so I haven't had any of their bodily fluids come into any sort of contact with me.  I'm not afraid of getting Ebola - at least, not while the number of people who have it in the United States remains comparatively infinitesimal.  Hundreds of millions of people live here, and only four have had it, so statistically, this should all be a non-story.  Experts tell us that if we really want to be scared about something, far more people will die of the flu this season.

Have you gotten your flu shot yet?  I have.

None of these diseases should scare us.  Instead, what should scare us is our own independence, personal defiance, selfishness, and the impunity with which we conduct ourselves in public.

Why?  Because if Ebola does spread, it will be because a certain number of human beings have acted irresponsibly.

A medical reporter, who herself is a medical doctor, went with a driver to a favorite gourmet bistro of hers in New Jersey after returning from covering the Ebola front in Africa.  But she was supposed to be under quarantine.  She intentionally and unapologetically broke that quarantine, assuming upon herself the likelihood that she wouldn't personally come in contact with anybody during the brief car ride from her home to the restaurant and back.

But what if she had a car accident?  Talk about greater chances - we Americans have a greater chance to be killed in a car wreck than dying of Ebola.  Besides, what if she was suddenly presented to the general population through some sort of unplanned event like a car accident, in which she may have required transportation to a hospital?

Or at least a concussion and bloody lip that a paramedic would try to bandage at the scene?

We don't like to impose such scenarios upon ourselves for a variety of reasons.  Thinking about the possibility of getting in a car accident is not pleasant.  Getting a paper cut, even, and bleeding on a countertop at our workplace isn't a pleasant thought, either.  Sneezing in an airport waiting area.  Gross.  But these kinds of things happen all the time, especially when we're not planning for them.  Even when we're taking deliberate steps to avoid them happening.

And it's not just us spoiled, self-centered Americans who live for ourselves first.  The Liberian who came and got the whole Ebola ball rolling in Dallas was a prime example of presuming that his personal actions either wouldn't impact anybody else, or would be somehow accommodated by everybody else.  And you know what- he got the first part wrong, but the second part exactly right, didn't he?  That whole hospital fell by his bedside when it was determined that he had Ebola, and his case has single-handedly marginalized the credibility of what used to be one of the most prestigious hospitals in the state.  Having the second nurse dash up to Ohio and back while she should have been under a self-imposed quarantine merely added insult to injury.

To be clear, it's true that the chances of other people catching Ebola from this jet-setting nurse and the bowling doctor are practically nil.  Just like the doctor who absolutely needed her gourmet soup.  As long as the circumstances remained ordinary, and they knew how to cover their face when they sneezed, the rest of us have been in no danger.

Here's the thing, though, and I repeat:  None of us can control all of the circumstances we encounter.  During a normal day, it's assumed that all of us need to take some rudimentary precautions, assess risks, and proceed with a certain level of prudence so we don't harm ourselves, and others, before the stroke of midnight.  But if we know we've been in the presence of something like Ebola, and if we know that the incubation period is 21 days, and that to quarantine one's self for that length of time might be inconvenient, but is also a mark of respect for the people around us, what should we do?

As we're learning, selfishness often trumps compassion.

What makes this worse is that so far, two of these Ebola patients have healthcare providers as employers; employers who should be the most sensitive to the need a skittish public has regarding quarantines for the people who've had immediate contact with other Ebola patients.  Sure, staffing becomes an issue at times like this, but can't salaries, overtimes, and even cross-employment matters be sorted out later?  21 days isn't the end of the world, is it?  Whatever happened to "better safe than sorry?"  Does that only apply to the bill-paying public?

America doesn't need to panic over Ebola.  However, in times like these, perception means a lot.  And, in case you haven't noticed, a full-blown panic is precisely what the media has been trying to foment out of these Ebola cases.  The networks can't sell air time and website ads based on four people getting sick.  Sure, a 25% death rate is pretty bad, but we're still not talking contagion.  Yet as long as the media can scare enough people into thinking we're on the brink, parents will be pulling their kids out of school, airlines will be backtracking their passenger lists, and Uber drivers will be dousing their backseats with Clorox (which, for any NYC taxi, public or private, probably isn't a bad idea anyway).

Since all of Ebola's American victims have been medical professionals, maybe there's some sort of special hubris among hospital staffers that makes them ambivalent regarding their chances of getting it.  Maybe they get cocky, figuring they know the symptomology and can self-diagnose better than anybody else.  Maybe the CDC, which so far has displayed a staggering amount of incompetence regarding our Ebola threat, has produced so much conflicting information about the disease that medical professionals are now jaded by it all.

But how many of us wash our hands when we use a public restroom?  How many of us cover our mouths when we cough?  How many of us cover our nose when we sneeze?  How many parents pull their kids out of school or church when they're sick?  How many of us refuse to take the flu shot for ideological reasons, or simply neglect to get the flu shot because we couldn't be bothered?  How many of us report to work even though we've got a cold or the flu, despite our employer's desire that we stay home and not get the rest of the office sick?

If you still believe anything the CDC says, consider these statistics:  between 3,000 to 49,000 people die of the flu every year in the United States.  Above 90% of these deaths occur in people 65 or older.  So maybe you figure that the flu only kills people who are past their prime anyway.  Meanwhile, you have a life to lead, fun to be had, and a job where few other people take sick days, so why bother?

After all, taking sick days can eat into your vacation time!

No, I'm not scared about Ebola.

Yet our human penchant for selfishness is another matter.

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