The Ebola issue
As it stands right now, I have mixed opinions about how to handle the Ebola question.
On one hand, the way that this outbreak is going on is a serious concern. The World Health Organization made a statement that it expects the number of new Ebola outbreaks to increase exponentially. But also in the number of health care workers that have been infected is also alarming. Also the lack of education about and fear of Ebola is doing about the same level of damage to the area. In short this is a issue that that cannot be handled without outside help. So on paper sending in military support to the area sounds good. We have done similar actions in the Philippines for Hurricane Haiyan. So why not right? Well there is the simple issue of the how.
The question is how are you going to fight it? Michael D. Lumpkin raised concern that the United States military is established more for trauma then for things like this.
“Our deployable medical capabilities are generally trauma medicine, treating people who suffer wounds in combat and things of that nature,”
The first question that I have is how does the DOD intend to adequately train 500 health care workers per week on how to care for infected patients. Also where are these 500 health care workers going to be coming from? The local population is not going to work due to the lack education and information on it. How are you going to staff the Ebola treatment centers when they are finished? Not to mention the risk of violence by the local population.
Also how are you going to prevent burn out from the health care workers?
In testimony prepared for the hearing, Brantly described the challenges and difficulties of working in what was already a “woefully inadequate healthcare system of a country still struggling to recover from a brutal civil war.” He “witnessed the horror that this disease visits upon its victims — the intense pain and humiliation of those who suffer with it, the irrational fear and superstition that pervades communities, and the violence and unrest that now threatens entire nations.”
Treating Ebola patients, he said, “is not like caring for other patients. It is grueling work. The personal protective equipment we wore … becomes excruciatingly hot, with temperatures inside the suit reaching up to 115 degrees. It cannot be worn for more than an hour and a half.”
Also is the question of how to handle treatment for potential infections of soldiers during the operations. From the reports
When he fell ill on July 23, “I came to understand firsthand what my own patients had suffered,” Brantly said. “I was isolated from my family and I was unsure if I would ever see them again. Even though I knew most of my caretakers, I could see nothing but their eyes through their protective goggles… I experienced the humiliation of losing control of my bodily functions and faced the horror of vomiting blood—a sign of the internal bleeding that could have eventually led to my death.”
Speaking for myself as a Licensed practical nurse, I would not have a problem going if called. However I would like to know what people think we can do in Liberia and what we actually do. Because a disconnect like this is going to get Soldiers seriously hurt or killed.
Category: Big Army, Foreign Policy
There’s another simple issue with the whole concept, Sporkmaster: hurricane or typhoon damage isn’t highly communicable, and it isn’t untreatable. And it doesn’t have a >50% fatality rate, either.
Ebola has all three.
“I got a really bad feeling about this . . . . “
But there are health issues that can come with it such as a lack of clean drinking water and sudden interaction of people from different areas that could introduce different pathogens to each other.
Not sure I understand what you’re saying here, Spork. Are you taking issue with my comment, or are you bringing up another group of reasons that this operation could be ill-advised?
I’m thinking the latter, but I’d prefer to know vice assume.
I was going with the idea that humanitarian missions like Typhoon Haiyan aftermath can have risks aide workers must deal with the possibility in infection. So to say the two mission are completely different is not entirely true.
I would not be worried about this type of mission if the only problem was trying to deal with the Ebola outbreak.
It is the lack of information about how the DOD is thinking of effectively using the Armed Forces to deal with this outbreak, deal with local unrest, and handle possible infection of Service members who might take part.
I do worry, even if all we do is attempt to assist in containing the Ebola outbreak. Ebola is qualitatively different from other pathogens we’ve run across during during humanitarian crises occurring since the development of antibiotics.
Ebola is (1) relatively easily transmissible, (2) has a high mortality rate (for this strain, best estimate is around 50% or more), (3) has no effective vaccine, (4) has no effective treatment, and (5) does not depend on a vector for transmission. It also has a substantial asymptomatic period after infection – which allows an infected individual to travel before he/she becomes infective and begins spreading the pathogen.
I can think of precisely two other diseases we’ve seen in the past 100 years or so that are even close. One is the pandemic flu of 1918-1920 – and if I recall correctly, its mortality rate wasn’t anywhere close to 50% (though in fairness, it was more easily transmitted; it spread by aerosol droplet vice bodily fluid contact). The other is Ebola’s relative Marburg. Marburg’s mortality rate isn’t as high as Ebola’s.
The historical parallels are smallpox and plague before effective preventative measures for either were known. But for smallpox we today have a vaccine; there are known treatments (curative or preventative) for plague. Neither exists for Ebola.
IMO we’re unnecessarily playing with fire in this case. And here, getting “burned” has far worse consequences than a blister or scar – not just individually, but potentially for US society as a whole.
President Obama has spoken, get your untrained asses to Africa and make those sick people well goddammit!!
No planning done, no idea of the logistical hurdles, no idea of what training is needed, no long range plan for sustainment. Islamic jihadi assholes running amok, superstitious, uneducated population prone to violence for no reason. Yeah, what could possibly go wrong.
But don’t worry people of Africa, Uncle Sam is coming, AGAIN.
The disconnect from reality on the part of the current administration is more disturbing than the proposal itself.
To send half-trained or untrained people to something like this, with no thought to the consequences, is so typical of what those morons do. But they get to ‘feel good’ about themselves, don’t they?
No good can come of this, in my viewpoint.
The disconnect is not just a singular group but nationwide. For example as a person in local government what a Forward Surgical Team can do.
Plain and simple: This is NOT a military mission. Providing security for trained medical personnel treating victims? Perhaps. Other than that, NO.
Out.
Although (having dealt with Liberians) the best way to make Liberians take proper sanitatry and medical precautions to prevent the spread of disease is probably at gunpoint, sending a whole bunch of troops to fight disease like it was something you could shoot is a bad idea.
So, any and all military personnel sent to Africa (or Mars – it really doesn’t matter the destination) degrade the ability of said military to conduct the military operations they were trained to do.
Personnel are assigned to do specific jobs. Send a bunch of them somewhere else and they are no longer available and other folks have to fill in. How does that work in the minds of the willfully ignorant?
These idiots apparently not only think that they are bullet proof (as in could never be the target of international thugs and terrorists) but that they are literally immune to deadly communicable diseases.
Here’s a clue, fools: You are not immune to these diseases, and neither are any of the rest of us. While I can take some measures to limit my exposure to disease, it is the job of the federal government to keep international carriers of disease from exposing us to whatever they have.
Close the damn borders! Isolate those with the disease from us. It’s the very least you can do.
You’re asking THIS administration to secure borders? Seriously?
More like demanding, but I expect the same reaction as from previous administrations to that demand. 😉
Perfect terror weapon. Send 10,000 newly infected folks home from Mecca and watch the world go nuckin-futz.
They are already teaching the next generation how to cope……. anybody notice all the zombies and redneck survivalist shows on tv?
Yup…and everyone makes fun of the redneck until the zombies show up.
better yet, send 10,000 TO Mecca the next time they do the haj…
I love how the media and others portray whole populations of people as victims to a traceable event, such as a civil war. Liberia was a shithole before its civil war and it most certainly is a shithole today. I’m sorry that we cannot save people from themselves, but we can’t. The one thing that provides some semblance of hope that governments worldwide will pitch in to contain Ebola is that the folks in government are as susceptible to contracting the disease as the guy over there waiting for a bus. When a threat can hit home for politicians, it tends to garner their attention and merit action. Ebola doesn’t give a rat’s ass what your social status or income is.
OWB above made some great points. First there are violent Muslims all over these areas. Bent on killing Americans as well as others. A perfect setup up for the ISIS promise to strike Americans directly. Next, the ill-informed and superstitious mindset of the population creates big problems. If they get it in their heads that the Americans somehow have the “magic voodoo” to cure this or save them, I can see the troop stations being overrun by sick people looking for that magic cure or the Muslim thugs thinking the same thing. Thus infecting all troops there. Superstitions are strong motivators and mob mentality is not something the troops will be trained to expect or deal with. I don’t know how well armed they will be but they should be given ROE for self defense. It would be sad to have to kill sick people but to save their own lives it could become necessary. Then will come the international condemnation and fall out from that. From all the nations and agencies who chose to sit this one out. As the article correctly states our military medical forces are geared towards trauma medicine not infectious disease treatment. Treatment…that is the big word. There really is no treatment. You can make the suffering comfortable and even try to educate them, a very long shot, but there is no treatment to administer. This is not a vaccination program for polio or other diseases preventable with vaccines. This is a disease with no known cure and the ability to mutate in days if not hours. Personally I think the WHO along with the UN (they have to be good for something once in a while) should form international medical teams trained for this type of work and rotate them in country in short tours. Military troops cannot take blood samples and swabs and such to take back safely for research. It’s just not their calling. However multinational medical teams versed in infectious diseases could. If they need troops for the medical teams protection, then again, what the hell else are UN security forces… Read more »
I have to agree.
While I feel like the *right* thing to do is to deploy forces for humanitarian reasons, it’s too damn dangerous.
We can’t let this spread. I don’t think we should kill anyone to accomplish that, but we sure as hell can’t deploy infantry to do the job of a trained doctor to treat it, and we can’t let anything leave infected areas.
Treat it like a steriotypical zombie apocalypse, except with less apocalypse.
“. . . do the job of a trained doctor to treat it, and we can’t let anything leave infected areas.”
In your comment lies part of the problem, Farflung Wanderer – as well as the only (at this point) reliable solution.
All trained doctors (or anyone else, for that matter) can do for an Ebola patient is palliative and supportive care – e.g., give them fluids and keep them as comfortable as possible. There is no effective treatment. An individual who contracts Ebola either lives . . . or they die. We can’t do anything to affect the outcome.
The Clueless Clown Crew running things in DC seem to think we can send a relative handful of troops and “fix things”. In reality, we can’t. Changes in behavior in the affected areas – and nature taking its course – are what will end the outbreak. And 3,000 troops aren’t going to be anywhere near enough to make much difference. Given the size of the area involved and the number of people living there, I doubt 300,000 would be enough.
Some problems simply don’t have an “easy” or “nice” solution. I’m afraid this may well be one such problem.
And for anyone who thinks we don’t need to worry about the possibility of aerial transmission, you just might want to read this:
http://www.foxnews.com/science/2014/09/19/how-virginia-suburb-became-ebola-epicenter/
At the Hazelton primate quarantine facility, primates that had never been in the same room with infected ones later became infected. The facility’s ventilation system is believed to have been the method by which the virus spread from the infected group to those in another room.
In other words: aerial transmission through inhaling the virus – just like one means the common cold, influenza, or smallpox is known to spread.
Even today, the researcher who first imaged the Ebola virus via electron microscope (and is one of the world’s acknowledged experts on Ebola) regards the question of whether airborne transmission of Ebola can/does occur to be “unresolved”.
I’ve got a buddy who worked for a while at USAMRIID. He was on their team which would fly around the world in response to outbreaks and he flew to Africa once to pick up a French doctor who was dying from Ebola. On the flight the doctor tried to describe what he thought was happening to him until he eventually died. That’s not a job for the weak of heart, and I fear that we do not have enough individuals ready to do that kind of dangerous, stressful work standing by.
Mark L. Opinions are like ass holes and you of course always have yours. However, a better post would be to address the true problem or even add your thoughts about a reasonable international response to this catastrophe. Poking the TAH bear is the wrong bait. Offer something constructive please and I will listen. Otherwise…well I don’t think I need type it.
Then you are a fucking idiot. I pray that you are not one of the ones sent.
I thought you were in Kuwait.
He claims to be. I think that – like our current
wannabe EmperorPOTUS he’s merely using the “royal we” here.I just spoke you your CIC Obama. He said he thought you were a “corpse man”. Said godspeed on a safe return. Said he will leave the teleprompter on for you and the door’s always open.
The problem is the “How”. Once the troops are there, what is the plan? How are you going to save a person from Ebola? From getting it or once it is contracted?
They will be in direct contact and I quote;
The United States Public Health Service Commissioned Corps is preparing to deploy 65 Commissioned Corps officers to Liberia to manage and staff a previously announced Department of Defense (DoD) hospital to care for healthcare workers who become ill. The deployment roster will consist of administrators, clinicians, and support staff.
Also considering that the incubation time between inoculation and symptoms showing is almost thirty days, it would be very hard to find out Soldiers did go into a infected area.
Now, Spork – don’t go confusing little Markie-boi here with pesky little things like facts. They sometimes make his tummy feel all twisty, and make his head spin.
And yeah, Markie – PHS commissioned personnel are considered members of the uniformed services. So at least some “troops” will be in direct contact with those suffering from Ebola, God help them.
Hey knife kill- you live in a Republic. You are an idiot, still.
Take that strawman!
And that!
And that!!!
The real problem with this disease has as much to do with superstitious locals as it does with how it is transmitted.
If even a burial team cannot do its work without being harassed and attacked, how is the spread of this fatal disease to be stopped? These aid workers are being blamed for spreading it, all based on superstitions and ignorance.
Aid workers trying to educate people in Liberia, Niger and Sierra Leone have been attacked and told there is no ebola wherever they are, that they are bringing it in. Ignorance and superstitious nonsense are nearly impossible to fight. If Sierra Leone has a lockdown so that the burial teams can get deceased people buried, and they are still attacked for doing so, how is this epidemic going to be stopped?
Oh, looky! Another bigot who takes out his racist tendencies on us.
How special. (Not)
OK, PVT SNAFU, we see that you’re doing what you can to be the biggest myrmidon you can for B. Hussein 0bama & Company. Me, I’m Combat Arms, thus I was at risk of receiving far worse injuries than the stapler malfunctions and paper cuts you risk in your job.
John Kerry had a knife kill, don’t ya know. What a fucktard.
Wow civil affairs guy … Tellin’ us how it is gouing to be.
This Mark fellow may be disagreeable and out of sorts with the group on this blog, but as I have pointed out before there is no doubt that the Civil Affairs CATs will probably be first on the ground. I will go further and surmise they will probably be Army Reservists, and if they are not then they should be. My current battalion commander (I’m the S6 for a Civil Affairs battalion) has done two tours to Djibouti, and most of his work has been infrastructure building and disease mitigation (malaria, in his cases).
We shouldn’t discount or underestimate the expertise of some of our Reserve Civil Affairs BNs, some of whom have professional doctors, dentists, and surgeons in their ranks. As bumbling as this administration is, I don’t think they would send 3,000 infantrymen when we have assets such as the Reserve Civil Affairs to draw upon.
CAS6: I do not doubt that CA folks will be among those sent. What I doubt is that they’ll be able to do much.
Countering malaria is a far different endeavor than countering a disease like Ebola. It’s a very different disease with very different characteristics. Methods to counter malaria are also well-known, and a lot is know about malaria itself.
Malaria has a low mortality rate. The worst form, falciparum, per published literature has a fatality rate of on the order of 0.333% to 0.667% (1-2M deaths out of 300M cases annually). Malaria is also vector-borne vice transmitted directly by personal contact. Preventive drugs and post-infection treatments are also available. None of that is true about Ebola.
Mosquito eradication/preventing bites is effective in preventing malaria – get rid of the mosquitoes or prevent bites, and you prevent human infection. Those are the primary public health measures taken to control malaria – mosquito eradication and bite prevention (mosquito netting, repellants, etc . . . ). (Prophylactic treatment against malaria is available, yes – and we use it for our troops in high-risk areas. But you generally can’t put a nation’s/region’s entire population on those drugs.)
Neither of those techniques does jack to prevent the spread of Ebola.
CA folks can and in fact do good work in assisting in malaria prevention and eradication efforts. However, IMO that particular expertise does not count for much when it comes to countering the spread of Ebola. The two diseases are completely different: different causes, different modes of transmission, different treatments, different mortality rates, different required preventive measures, you name it. Procedures for countering them will thus be very different as well.
It is curious that military folks were apparently prepared to be sent into this on short notice. Having been to a few rodeos myself, I have a couple of questions about that aspect:
Who exactly are they sending? When did they start training for this specific contingency? What precisely is the mission?? And what is the exit strategy?
This could easily be the realization of my worst nightmare – sending our troops somewhere and just leaving them there until they are all dead.
Here’s a little quote from Markie-boi:
‘I could care less about getting infected myself.’
http://valorguardians.com/blog/?p=55302&cpage=1#comment-1826143
Either he posted that in complete ignorance of the way this disease destroys its host – it rots you from the inside out – or he has a suicidal mindset. Or both.
Either way, it would be nice to know if his boss knows about his attitude. I would definitely NOT want someone with such a malcontent attitude working for me in this venue. EVER. All he will do is put other people on his team at risk, in this case, extreme risk.