Houston Chronicle. Oct. 27, 2014.
Ebola lessons: Amid this public health scare, keeping our wits about us is the best prescription
Now that the Ebola crisis and attendant panic in Dallas seem to have abated, maybe we can take a deep breath - remember, the virus is not airborne - and determine what we’ve learned that might serve us the next time we confront a public health threat, whether it’s Ebola or something else.
The most obvious lesson must surely be to keep things in perspective. Certainly, Ebola is terrifying, but the fact is, it has killed one person in the United States, a Liberian man who arrived in Dallas with no temperature or no symptoms when he passed through screening in his home country.
The vicious jungle virus has a long way to go before it matches the flu, which kills 40,000 Americans every year, or traffic accidents (34,000), or guns (30,000). It has a long way to go before it competes with the 1918 flu pandemic, which killed 675,000 Americans and an estimated 30 to 50 million people worldwide.
Our fears are irrational and yet understandable. “You can do certain things to avoid the flu,” Dr. Kyle Janek, commissioner of Texas Health and Human Services, pointed out last week in a conversation with the Chronicle. “Folks are afraid of Ebola because they don’t understand it, and they know it’s a quick, horrible death.”
Our fears, however understandable, could be more of a problem than the disease itself for those of us far from the source of the disease in West Africa. Panic unduly burdens hospitals and local health facilities, sows distrust among neighbors and pressures elected officials into making unwise and impractical decisions. That’s one thing Texans will have to be on the lookout for when the Legislature returns to Austin in January.
State agencies responded sensibly, for the most part. As Janek noted, “Everybody could see this eventually coming. We didn’t know when, we didn’t know where, which makes it difficult to plan for. The Dallas case forced our hand.”
A Texas Task Force on Infectious Disease Preparedness and Response, formed by Gov. Rick Perry in early October, has called for the creation of two Ebola treatment facilities, in Dallas and Galveston. Task force members acknowledge that it would make no sense for hospitals around the state to buy equipment and construct specialized units for an illness that most will never see. The task force also ought to review coordination among county, state and federal officials.
Certainly, hospitals and local caregivers need to be aware, in ways they might not have been before the Dallas case. “This is the new normal,” Brett Giroir, director of the governor’s task force, said last week at the conclusion of a hearing in Austin.
Part of the new normal, we would suggest, is for Texans, indeed all Americans, to look beyond our borders and encourage efforts to halt this public-health disaster at its source.
Obviously, this country and other countries with advanced health systems can protect themselves against Ebola outbreaks, but in West Africa the number of cases is still doubling every two to four weeks. Liberia, Guinea and Sierra Leone need American troops to help fight the disease. They need doctors, medicine, equipment. They need United Nations help and donations from individuals and organizations.
Here at home, officials need to plan, prepare and protect, but the surest way to protect both ourselves and thousands of West Africans is to fight this scourge at its source.
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San Antonio Express-News. Oct. 27, 2014.
Ebola travel restriction could make things worse
Restricting travel between the United States and West African countries facing the Ebola outbreak has become a popular talking point with many politicians, especially here in Texas.
It sounds simple. To reduce exposure risk for U.S. residents, we should restrict or ban travel between the United States and Liberia, Guinea and Sierra Leone where the outbreak rages. While this sentiment is understandable, it’s one that could possibly worsen the Ebola crisis, public health officials have warned.
For starters, it could limit the ability of health workers to travel to West Africa. Already, health and aid workers are struggling with limited commercial flight options.
A ban might also hinder the ability of international groups to recruit health and aid workers who might fear being stranded from home. And it could encourage people to go underground to avoid screenings, or simply head to other nations, allowing the disease to spread in surprising ways.
The recent move to direct all travelers from the three West African nations to five U.S. airports strikes a better balance, allowing health workers to track the travels of any person who might be exposed to Ebola.
Unfortunately, draconian quarantine policies in New York, New Jersey and Illinois - where mandatory 21-day quarantines are somewhat vaguely in place - aren’t helping matters.
The treatment of Kaci Hickox, a nurse and epidemiologist with Doctors Without Borders, is particularly troubling. She was held in a spartan tent over the weekend in New Jersey until finally being released Monday. Hickox served on the front lines of a crisis and should be treated as a hero. We need more volunteers like her.
As of this writing, more than 10,000 cases of Ebola have been documented in West Africa during this outbreak. The World Health Organization has said if the international community does not step up its response to the Ebola outbreak, West Africa could face 10,000 new Ebola cases a week by December.
By comparison, there have been four documented cases in the United States, and only Liberian Thomas Eric Duncan has died.
As the world’s leader, the United States has a moral obligation to help control this outbreak. But as a matter of pragmatism, the best way to ensure Americans don’t contract Ebola is to control the outbreak in West Africa and help lead the charge on vaccine development.
A travel ban and draconian quarantines do a great job of driving political fear. Unfortunately, they do nothing to end the Ebola outbreak or necessarily make Americans safer from it.
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The Brownsville Herald. Oct. 22, 2014.
Panic attack
In the month since a Liberian man fell victim to Ebola in Dallas we’ve seen a flurry of activity and heard plenty of chatter about it. Congressional hearings have been held and some people, including our Gov. Rick Perry, have called for travel bans from certain countries. Passenger screenings have been stepped up at many airports.
President Barack Obama even has announced the creation of a whole new bureaucracy that will support an “Ebola czar.”
All for three outbreaks and one death.
Some people suggest people have overreacted to the issue, largely due to intense media coverage and the pontificating of officials who want to convince voters that they’re on top of the matter.
Part of the problem is our lack of knowledge about the Ebola virus and its effects. Likewise, suggestions of overreactions indicate many people might see the precautions as extraordinary, knee-jerk reactions. They’re not.
Rio Grande Valley residents and others who have visited certain parts of Mexico and other countries have encountered questioning that might be more intense than normal when they re-enter this country. They also might be surprised if they offer to donate blood and are turned away.
It’s because the same travel precautions that have kicked in regarding Ebola already are utilized in areas in Mexico and elsewhere that have had outbreaks of dengue, cholera, tuberculosis or other contagious diseases.
Those diseases don’t cause the same panic, because we’re more familiar with them and people might be more confident in our medical system’s ability to deal with them.
Similar knowledge about Ebola likely will help calm our collective fears. Certainly that will come, but the Dallas cases are the first that have been diagnosed in this country. So strong reactions to admitted errors by hospital staff and officials with the Centers for Disease Control and Prevention in handling these three cases might be unreasonable.
Fortunately, we can learn about Ebola and other maladies without enduring outbreaks in the U.S. America’s affluence, and altruism, has led many doctors and other health-care workers to go to Africa to treat the disease. And of course, working with patients directly is the best way to learn about the disease - its symptoms, effects, incubation, etc.
The next step is to determine the best way for those hands-on caregivers to share their knowledge and experience with others, so that we can improve readiness, and ensure that staff knows what to do, at all U.S. medical facilities.
Certainly we don’t want to see military-like debriefing from our government. But the CDC might be able to use current technology to create questionnaires or open forums through which people who have dealt with public crises in other countries can relate their experiences both to public officials and the public in general.
Knowledge is power, and it also helps allay fears. With Ebola as with any other issue of public concern, any process that helps increase our knowledge would benefit us all.
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Fort Worth Star-Telegram. Oct. 27, 2014.
Welcome home, Nina
After seeing her sparkling smile and noting the warm embrace she received from President Barack Obama on Friday, it is hard to believe that just two weeks ago, nurse Nina Pham was stricken with a disease that kills more than two-thirds of its victims.
The Fort Worth product has quickly become Cowtown’s Ebola success story - and her victory over the disease helps brighten some of the darkness and frustration that has marked the state’s mixed experience with containing and treating the illness.
Pham was part of the medical team that cared for Thomas Eric Duncan, the Liberarian man who succumbed to Ebola in Texas Health Presbyterian Hospital Dallas on Oct. 8.
Thanks to the care received first in Dallas and then at a medical facility in Bethesda, Md., Pham has been declared Ebola-free.
Dr. Anthony S. Fauci, one of the doctors who treated Pham, described her as “extraordinarily courageous.”
For her bravery, first in caring for a victim of the devastating illness, then in overcoming it herself, she is certainly a hero.
We are overjoyed that she has recovered. And Fort Worth is proud to have her back.
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The Dallas Morning News. Oct. 25, 2014.
Inching closer to paying college players
To put to rest last week’s online kerfuffle, the University of Texas isn’t about to open its impressive checkbook to start paying its student athletes for scoring touchdowns and sinking three-pointers.
This may be the future, but let’s not get ahead of ourselves.
Athletic Director Steve Patterson answered a hypothetical question at a forum on the business of college sports. If the NCAA did not prevail in appeals of rulings related to play-for-pay, what then for UT?
Note, please, the “if.” Patterson wasn’t saying that the nation’s most profitable athletic program was taking matters into its own hands - in the absence of new rules - to start putting real cash in athletes’ pockets. What he did was put a dollar figure on the supposition. But that in itself is a valuable exercise that reinforces how close this might be.
For the record, his estimate is $10,000 per athlete over 600 scholarships in all men’s and women’s sports, or $6 million per year. That’s barely a rounding error in UT’s athletic budget, but it would be real money if a Southern Methodist University or University of North Texas tried to match it.
One difference is that UT is in a so-called Power Five conference. The Big 12, Southeastern, Big Ten, Pacific 12 and Atlantic Coast conferences have the pedigree and leverage - i.e., revenue - in today’s college sports. Because of TV deals and historic market forces, Power Five revenue is a raging river compared with other Division I schools’ babbling brook. Yet precious few athletic programs are entirely self-supporting, so any change affects overall university budgets nationwide.
Patterson estimates $5,000 annually per scholarship athlete for compensation from what is commonly called the O’Bannon decision. In it, a federal judge found that the NCAA unreasonably restrained trade by prohibiting athletes from selling their names, images and likenesses.
The other $5,000 is to bring the value of each scholarship to what’s known as full cost of attendance. That means adding annual money for incidentals to the traditional tuition, books, fees, room and board. It would vary for other universities based on cost of living, probably higher for Berkeley, Calif., than for Austin or Dallas.
Separately, the National Labor Relations Board’s Chicago office ruled that Northwestern University had to allow its football players to vote to form a union, declaring them school employees because of their extensive football hours. The NCAA is fighting both decisions through appeals that could take years.
Still, it’s clear that the system is changing, and Patterson and other athletic directors would be wise to plan for that eventuality by banking some cash today.
That $10,000 or so would be deserved compensation for those who receive it, given the massive revenue at top-level schools. The workers who create the product should share in the bounty.
But don’t pretend this is the only consequence. The gulf between have and have-not schools - Power Five vs. the rest of the NCAA, Texas vs. SMU - also will grow eventually to a completely different place.
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