To think that if you were part of a medical team treating Ebola

[maddening]

That you would quarantine yourself from family and the world at large for the period and the incubation period - reading news of health workers families and friends being quarantined now there is a possibility of contracting from their loved one, plus exposing the public.

These people are so brave and to do what they are doing and risking their own lives is the ultimate thing that one can do - but surely if you volunteer or accept this job in particular then surely they should have been given a living space for the period and then for the period following their work - so 21 days after last contact with patient.

I know that health professionals are regularly in contact with infection and risk passing it on - but an illness which is so contagious and deadly in it's mortality rate is a different matter.

I also know it would be a massive ask after what they have already done in doing this job but if it were me I wouldn't want to risk my family and friends - they didn't sign up for this. And surely if we are trying to contain this so it doesn't get out having people with know contact - albeit with maximum protection - the risk is still elevated and coupled with the impact this has on others lives - so ending up with 20 people who have to stay in quarantine as they had substantially less protection when in contact with their loved ones - let alone complete strangers and their families.

Anbu to think these very brave health workers who are to be commended for everything they do should have been offered the chance to quarantine themselves or quarantined as comfortably as possible for the period.

While they have protective clothing, removing that clothing is always a risk. A couple of seconds lapse in concentration at a crucial moment could be the difference between infecting yourself or not.

Relatively few of the well trained MSF HCPs have been infected. Most of the infected workers are local HCPs and may not have been working in the Ebola treatment centres where there is PPE. Some of the clinics are lacking in basic equipment such as gloves and masks let alone full suits. AFAIK at least one of the infected US doctors had never been near an Ebola treatment centre, he caught it off a patient he treated in his role as an obstetrician.

Given how bad some of the conditions are reported to be out there I am actually surprised more HCPs haven't been infected.

treated like a hero or a criminal?

You are probably right, but the reality for many is this. Nurses aren't even being fed or paid properly never mind the luxury of isolation. Lots more resource needs throwing at this and quickly.

If she was properly in isolation I might agree it's not too much of a hardship just a massive inconvenience.

But she's in an unheated tent wearing paper scrubs in October. If she's lucky it won't fall below 10 degrees at night. I'm not sure at what point they're going to find somewhere inside to isolate her. It's not sounding like much of a luxury at the moment.

It does sound like they are treating that US nurse in an appalling fashion. Hysteria has broken out.

The MSF protocols for staff returning from Ebola-affected countries state that staff continue to be paid during the 21 days after return from duty in West Africa, as MSF feel they should not return to work in this period, so a quarantine should not deter volunteers from a financial viewpoint. It also implies that they are not unpaid volunteers when in West Africa (although we don't know what rate they are paid).

The US doctor now infected in New York said he felt 'sluggish' for 2 days before getting a fever. During this time, he travelled on public transport, used taxis and went bowling. I do think if I had been him I would have been hyper-vigilant and would have stayed at home a lot more, especially in such a populous place as New York. I guess the authorities now feel that they can't trust individuals to self-monitor, but it seems like they have adopted a very heavy-handed approach.

MSF US says it pays a gross monthly starting salary of $1,731. I hugely admire everyone who has volunteered to work out there. Donate to MSF here www.msf.org.uk/make-a-donation :)

Wow the responses to that article are just appalling. People are incredibly ill-informed and the amount of hysteria is very concerning. Much of it is self inflicted by the US authorities too (eg unnecessary contact tracing, totally disproportionate to the actual risk, but in pre-election times not that surprising I guess)

There is a college in Texas that has decided to deny all applications from anywhere in Africa because of the Ebola 'risk' - logically that means they should deny applicants from both Spain and the US too as they have both had cases, but of course not. And they are in Texas! Some of these attitudes are I suspect informed by racism in the same was as the way that HIV was thought by many about supported their homophobic opinions.

Ebola Facts: How Many Ebola Cases Are Outside of West Africa?
At least 18 cases have been treated outside of West Africa since December 2013 ie not including Nigeria, Senegal, Mali, DRCongo

USA
1 New York - in treatment
2 Dallas - died
3 Dallas/Bethesda - recovered
4 Dallas/Atlanta - recovered
5 Omaha - recovered
6 " recovered

7 Atlanta - recovered
8 " recovered
9 " recovered

Europe
1 Leipzig - died
2 Madrid - died
3 " died
4 " recovered
5 Oslo - recovered
6 Hamburg - recovered

7 London - recovered

8 Paris - recovered

9 Frankfurt - in treatment

From New York Times 25 Oct 2014

I think there might be 1 more European case. I remember reading that the man who died in Leipzig was the 4th case to be treated in Germany. I can only see 3 on the NYT list.

Looking at that list, only 2 of the cases have returned from West Africa with an unknown Ebola infection (1 &2 on the US list). Most of the rest were returned home for treatment. So far only 2 cases (Dallas and one of the Madrid ones) have led to an outbreak in the country treated. And those were both in HCPs with close contact and not the general public.

MSF have sent out over 700 HCPs to West Africa and only 3 have been infected with Ebola. That suggests that this Ebola virus is acting exactly as we expect it to based on our knowledge of how it is transmitted.

Agree with OYBBK. I am not aware of ANYONE catching Ebola from a non-symptomatic, or very early symptomatic, person in a public place.

Yes of course take the temperature of anyone who has been exposed to Ebola twice a day and set up a protocol so that they can get tested in a quarantined area if they're feeling off colour and go straight into a prepared Ebola medical facility at any signs of the disease.

But chasing up taxi drivers of asymptomatic victims is unnecessary and just spreads panic.

If you exclude those who were deliberately transferred for treatment, the figures are even lower:

If you look at 'fell ill whilst in Europe or USA' (either traveller or contact) then it is 5 cases.
If you add non-outbreak Africa, it's around 10 cases.

ROW, 0 cases.

Volunteers will have to come back three weeks early, I suppose. Who is going to find them solo accommodation (if they do not own their own) for the quarantine period? Or will the charities have to fund that, as well as deal with the consequences of shorter periods in country from the trained staff they are crying out for.

why be in isolation when you are not contagious? makes no sense at all.

MSF guidelines which are very clear about what to do and why. They don't recommend quarantine, they do recommend refraining from work to avoid picking up bugs who's early symptoms could look like ebola and so that people can rest.

Think of the message this sends back to West Africa. There have already been massive problems with some people there believing that westerners are spreading the virus and refusing to let them in.

If they hear that we are now quarantining the doctors and nurses who treated them then how can they trust those healthcare workers when they are over there? It makes their position untenable if the locals believe that asymptomatic healthcare workers are carrying and spreading the virus. It undoes months of hard work earning trust.

Badly thought through PR would be my guess sanfairyanne.

They felt the need to reassure by doing something. Quarantining returning aid workers fits the description of looking like you are doing something. The fact that 99% of them won't have Ebola, and even if they did are not contagious while they are asymptomatic is irrelevant.

Unfortunately it conflicts with the message they are trying to get out that Ebola is not contagious in the early stages. I think what might happen is that people are going to end up reasoning that if Ebola wasn't contagious there would be no need to quarantine therefore it must be contagious and the government are lying. Which is probably not the result they were looking for.

The ebola issue has become so horribly politicised in the US in the context of the mid-term elections in 9 days time and conflict over Obamas healthcare reforms, such that some of the panic/spreading misinformation almost seems deliberate

''The risk, Mr. Cuomo said, was grave. Offering an ominous hypothetical, he raised the precise situation that the mayor and the city's health commissioner had tried to play down the night before: the danger of Ebola spreading through the subway system.

"In a region like this," Mr. Cuomo said, "you go out one, two or three times, you ride the subway, you ride a bus, you could affect hundreds and hundreds of people." '' yesterdays New York Times

Governor Cuomo is one of the 2 governors who has enacted the quarantine legislation in Newark and is currently campaigning for re-election on 4th November.

Today, the quarantined nurse, Kaci Hickox aka 'Ebola Nurse' is being vilified by respected commentators as a ''whining Democrat'' and ''CDC hack'' for her essay in the Dallas News, quoted above. Can't read or link to her original essay as the website dallasnews.com/ebola seems to be down/ overwhelmed/mumsnet is too slow.

Not so respected commentators continue to promote their conspiracy theories that Obama is deliberately trying to introduce Ebola into the US for population control etc

or could they just blood test all returning personnel to identify those definitely infected?

Wouldn't work. You'd have to be quite obviously ill before the blood tests would show an infection.

"or could they just blood test all returning personnel to identify those definitely infected?"

Agree with Rafa. Your viral load is only high enough to be detectable at a minimum of 24 hours after symptoms show. But even in early symptomatic stage, it might not be high enough fo its presence to be revealed by test, so a second test is carried out a minimum of 48 hours later.

So to make this work, you would need airside isolation facilities (with individual rooms) and - if you are seriously following Cuomo's scary views on transmissibility by sharing transport- that can hold every single person on those planes for a full 23 days (incubation plus time for final test). Plus a new BL4 lab for all the tests.

Who will pay, if they are going to do it thoroughly? I doubt that charities can afford this.

Or is it all just posturing? Because what will be achieved, if it's going to continue half-assed and misguided as at present?