Monday, October 27, 2014

Politics and Medicine

I went away this weekend, and for a moment forgot about all of the latest craziness Americans and especially New Yorkers are being drowned in.  I was happy to read that New Jersey and New York announced a plan to quarantine those returning medics from West Africa. It would be far more effective to quarantine everyone coming here from the 3 countries most hard hit by Ebola, but that would be too logical and our government has a very short supply of common sense.  These logical steps were reversed as soon as chief Obola inserted his medical opinion.

The nurse who was inconvenienced at Newark airport found willing media outlets to carry the CDC message that quarantines and travel bans are not needed. There is a story in AP praising doc Spencer for running a marathon and traveling all over the world to see sick people.  I guess all of us should feel privileged to risk our lives because this Spencer is such a great guy and now we can all share in his dangerous adventures.

This afternoon, I read a NYCDOE notice.  "New York City is collaborating closely with its state and federal partners to protect New York children and families.  The risk of infection in New York is extremely small, and we hope this information will ease any concerns that you might have:
- All NYCDOE school nurses and medical providers in New York City have been prepared by the Health Department to look for signs of Ebola and take immediate steps to isolate those who may be infected..."

Wow, now I am really, really, reassured and at ease. The school nurses are being trained on how to recognize Ebola?  No one can tell the difference between Ebola and the Flu, or even the common gastroenteritis, in the beginning.  By the time you see the bleeding component of this illness, it is too late to do anything. However, I am not the school nurse. I am just a doctor who works at a city hospital. The only method we had to figure out who was at risk, was the travel history. After our hero-doc Spencer went bowling and rode the subway, that bit of useful information will soon become useless. I predict in about 1 month. Personally, I believe his medical license should be taken away for putting a whole city at risk and acting irresponsibly.  On the other hand, his behavior will probably be irrelevant because our borders are wide open and potential carriers are flying in daily.

My own hospital-wide updates sound schizophrenic and change almost daily about how to handle potential Ebola patients. Like I said in previous posts, the NYC hospitals are not equipped to treat such patients and they will not be anytime soon. We have no decontamination areas and no one I work with has any experience using these hazmat suits, that is if one can find such a suit.  I think my hospital has about 6 of them and very few people know where they are being kept.

Soon we shall see if the nurses and doctors at Bellevue are any luckier than the staff in Texas were. If they don't become infected, it will be through pure luck and little else. Some of the hospital staff who didn't feel so lucky apparently called in sick, in record numbers.  The ones who are being sent in to care for Spencer, have a very reasonable "Why me?" attitude. If Spencer lives, then he might be of use taking care of those sick and dying in this city due to a disease that he helped spread through NYC. If it spreads, and at this point it is really more of when than if, there will be a severe shortage of medical staff here.

Quarantine is the only effective weapon we have at this point, and the feds are not letting us use it.  It makes one wonder if politicians have always been this bad for our health. I don't think so because if we had such brilliant leaders 97 years ago, then the Spanish Flu would have taken 70% of humanity rather than a mere 1/3.

Just as it was before I left the city for the weekend, our only plan is to hope this pandemic blows over and to keep reassuring the public that all is well. I don't think anyone has even called it a pandemic yet even though it has already spread to 3 continents. It could have been only an epidemic, if we instituted proper quarantine measures, but we didn't because such measures were not appropriate politically.

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