Ebola Update- A Broader View, and a Clarification from Hathaway Brown

Ebola Update- A Broader View, 

      and a Clarification from Hathaway Brown

[as of October 17, 2014 at 8:45 AM]

As we take a look at the state of the Ebola virus in the United States at this time, a few key observations seem most relevant:

1. We have had two phases of the infection, and wait to see if other phases will develop or not.
2. The first phase was the arrival in the United States of a small handful of people who got the Ebola virus infection in Western Africa, primarily Liberia.  By a small number, we mean less than a dozen.
3. The second phase has been the spread of Ebola virus from those infected in Africa to people in the United States.   At the time of this posting, a total of two people have been infected in the United States.  Further, everyone who has actually been infected by Ebola virus in the United States has gotten infected only by caring medically for a person ill with Ebola.
4. There has been no third phase of infection at all so far.  Of course, it is too early to know if there will be a third phase, but as of today, we know of no one who has actually been infected by either of the two nurses, the only people who actually got infected to date in the United States.

The Broad View, Right Now

These facts lead to the following observations:

• Ebola is a scary illness because it is so deadly and there is no specific treatment for it.
• There is no Ebola epidemic active at this time in the United States.  Out of a population of 300 million people to have a disease spread to a total of two people does not constitute an epidemic.  
• It is also striking that the only people who have caught Ebola infection in our country were two nurses who were placed in very close physical contact with an infected person's bodily fluids.  Early reports suggest their infection may have resulted from breaches in protocols that can protect medical caregivers.  If so, the only documented infections in the United States, to date, are the result of something almost none of us will be actually experiencing- providing very close medical care with someone dying of Ebola infection and doing so with breaches in the proper technique.
• At the same time, very careful vigilance is in order to prevent or minimize a third wave of infection, the spread of the Ebola virus from the two nurses to others.
• The main observation to make at this moment is that although Ebola is raging in Sierra Leone, Liberia, and Guinea, it is really not raging in the United States.  At this time, there is very little danger of infection to nearly all of the 300 million people who live in the US.
• And again, the experience of Nigeria is instructive.  Even if a third wave of infection occurs, this disease is containable, and I have every confidence that if a third wave occurs, the US will be able to keep it from actually moving into epidemic mode.  That is, we are all very safe right now, and the outlook remains very good that we will continue to be safe.

The Clarification from Hathaway Brown

A number of highly reputable news sources reported yesterday that at student at Hathaway Brown was asked to remain home yesterday because the infected nurse who flew from Cleveland had visited the home of a Hathaway Brown student.  Please note that these news reports, and my posting, were very clear to avoid stating or implying that anyone else at Hathaway Brown actually was exposed to a contagious person.

Hathaway Brown has clarified what took place.  It does turn out to be true that Hathaway Brown asked a student to stay out of school pending further information, and asked her to stay home because of a possible exposure.  The clarification is that the exposure was not to the infected nurse, but to a person who was a passenger on the plane with the infected nurse.  But that passenger and the infected nurse shared a flight on October 10, not the 13th, that is, the flight to Cleveland, not from Cleveland. At that time the infected nurse was most certainly not contagious, if it remains true that her first symptoms occurred on October 13.  As Hathaway Brown put it in their statement, they asked their student not to attend school for now, out of "an abundance of caution."

In re-reading our post yesterday, it is clear that our message was not that any risk of infection with Ebola had come to the Hathaway Brown community.  This welcome clarification from Hathaway Brown makes this point even more emphatically.  These facts, as we currently understand them, establish that the student was never in contact with anyone who could have been contagious.  It makes sense for any school to be cautious, we make no comment on the whether the student should attend school or not, or when.  But we can say with this clarification, and assuming no new facts emerge, we still have no reason to believe anyone in NE Ohio is infected with Ebola virus.

Bottom Line

This virus is very scary, for good reason.  Fortunately, it has not spread in the United States to any degree that makes us think we are in any danger.

Let us hope this remains the case, even if several more cases of infection are identified.

Here is to your health, and to this threat passing as soon as possible.

Dr. Lavin

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