[googler_314]

Before judging this man for going bowling etc., we should bear in mind that he caught Ebola working for Doctors without Borders in Guinea. I would guess that without workers like him, the risk to Americans and others outside Africa, would be much higher, since the disease would be spreading much faster within Africa. Hopefully he recovers and we can improve travel policies if necessary.

[rustyconover]

To borrow an idea from math, "doing good" isn't a commutative, infections and diseases are. Have some respect for others and slow your roll before going out during the 21 day post exposure window.

It's a bit like saying, "Hey I've saved lives over here so I have earned the right to be irresponsible over here". Because you know, karma balances out. No, the world doesn't work like that. And you aren't doing any good propagating this idea either because it encourages this privileged way of thinking.

As much as this guy isn't being vilified (and say what you want about the government spinning its story of ebola being hard to transmit), lets think clearly and rationally. He knew the risks that he could possibly be infected and decided to endanger others when he could have easily stayed home or gone anywhere to a more isolated environment (upstate NY is calling). It is well known symptoms generally show up by the 10th day. Today is his day 10.

It's very interesting that the government has locked down this guys apartment, yet if you need contact with bodily fluids to contract the disease why quarantine the apartment and surroundings? Could it be that droplets are a transmission method as many people are starting to suspect. Sneezing and coughing may spread these droplets to the floors and walls? And if that is the case, what about other objects that come in contact with saliva and other fluids like utensils, door handles, glasses...

[ChuckMcM]

   > He knew the risks that he could possibly be infected 
   > and decided to endanger others when he could have 
   > easily stayed home

That may be over stating things. Given that he is a doctor, and he is confident in his process with keeping clean, he might actually have a really hard time believing that he was infected. People have faith in their own abilities, that lets them do things which might put them at grave risk.

In the military service you will hear it as "trust in your training." Basically you believe you won't be the guy that gets shot or steps on a land mine or what ever because you trained really hard and you know you are implementing that training flawlessly.

It is entirely possible this person was so confident in their training, and their own competence in putting that training into action, that they believed it was impossible for them to be infected. They do the self monitoring because that is what you are supposed to do, but it never comes up positive because you did what you were supposed to do. This gets worse the more times you do something and the outcome is exactly as you expect it to be.

So I can believe this guy didn't believe he was at risk. Just like I have foolishly believed this small change I am checking in can't break anything[1]. One hopes he was asymptomatic when he went out. Unlike the guy in Texas who was showing symptoms and went home, or the nurse who had a fever and got on a plane anyway.

Sure you could put anyone coming back from West Africa in an airstream trailer [2] for 21 days but that is impractical if you want to support the process of fighting it in West Africa.

[1] I know, hugely different scale, but illustrative of my fight against my own assumptions in the pursuit of better process.

[2] http://en.wikipedia.org/wiki/Mobile_Quarantine_Facility#medi...

[001sky]

"Given that he is a doctor, and he is confident in his process with keeping clean, he might actually have a really hard time believing that he was infected."

Unless you are in proper (BSL-4) lab, the sad reality is there will always be risk. I hope that MSF doctors and volunteers are well protected. But it worries me that they would even contemplate believing that they have zero risk of exposure. That's simply not scientific or a professionally responsible. Although, to be fair, the CDC was guilty of making this same assumption up until about two weeks ago.

It makes more sense for them to spend 21 days self monitoring (in a secluded environmnet) locally in country. There is no need for a complete travel ban, but a staged ingress/egress process would make sense. And certainly we don't need to be issuing sight-seeing or tourist visas etc. Critical business travel could also be easily arranged for with a built in waiting period (most visas take 2-6 weeks anyway to issue).

[malandrew]

You can fight the deleterious effects on support of quarantining by making the quarantining fun/enjoyable/pleasant. Choose a remote resort location, rent it out for the duration of the crisis, send everyone there to sit out their quarantine in comfort.

I wouldn't mind a 21 day quarantine on a beach or camping

[TrevorJ]

You can't send everybody to the same quarantine, they would all end up infected.

[jeffdavis]

But you can send them to NYC instead?!

[steve19]

I don't know much (well, anything really) about disease transmission, but should these health workers not quarantine themselves away from the immediate vicinity of the infection, but before taking a cross-Atlantic/Pacific flight where they could infect a number of other people in close proximity?

I would have through the health agencies they volunteer with would enforce these kind of quarantines to prevent international transmission of disease.

On one hand I can't help admire these people risking their lives to help people on the other side of the world. On the other hand some of them seem content to play Russian roulette with their neighbors and family back home, which makes no sense to me. Is it as the OP suggested that doctors make for bad patients?

[blergh123]

I thought it was well known that ebola can be spread through any bodily fluids and that this includes droplets from coughing and sneezing. What they don't yet know is whether ebola is 'airborne' - i.e. dried droplets that can float in air as is the case with measles for example.

[rustyconover]

If you asked 10 average people what they think "airborne" means in this context, I doubt they'd say there is a difference between wet and dry transmission. I'd say for the purposes of argument, if a guy coughs violently on you because he's sick there is risk you could get Ebola. If a guy vomits in the subway car, apparently there is a risk of Ebola transmission. I've been on the subway cars and in taxi cabs it happens more than you think. Do you think they bleach all of those things adequately? No way, the financial incentives don't align to properly do it.

The government is using semantics and spin to their advantage by saying it isn't airborne via dried viral transmission. The WHO agrees[1] that it also isn't airborne, but also admits surfaces can transmit the virus.

Most officials omit this detailed explanation since they have no adequate explanation of how to decontaminate the urban environment en masse if an outbreak does occur.

In the end we all have to assess our own risk profiles. Will I stand or sit next to somebody coughing? I doubt it. Or will I take mass transit if I can easily walk to where I need to be by leaving a bit earlier? Nope.

[1] - http://www.who.int/mediacentre/news/ebola/06-october-2014/en...

[hackuser]

> I thought it was well known that ebola can be spread through any bodily fluids and that this includes droplets from coughing and sneezing. What they don't yet know is whether ebola is 'airborne' - i.e. dried droplets that can float in air as is the case with measles for example.

I would suggest to everyone: Don't comment on questions like this one (how Ebola spreads) unless you know for certain what you are saying and can back it up. We have complete saturation of rumors and bad information; adding to it won't improve the situation.

I don't mean to criticize the commenter above; they just happened to have the top-most comment of this kind.

EDIT: What a strong signal of over-reaction when a post that says you should know what you are talking about, on HN, is modded down. (I don't care how it's modded, it's just depressing to see this response here.)

EDIT: The same applies to my other post, which asks serious, legitimate questions in a non-offensive way. How sad.

[001sky]

This (above) comment has no citations and the one you are responding to (GP) is substantially correct.

http://www.ncbi.nlm.nih.gov/pubmed/15588056

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113787/

Ebola and Marburg viruses are the sole members of the genus Filovirus in the family Filoviridae. There has been considerable media attention and fear generated by outbreaks of filoviruses because they can cause a severe viral hemorrhagic fever (VHF) syndrome that has a rapid onset and high mortality. Although they are not naturally transmitted by aerosol, they are highly infectious as respirable particles under laboratory conditions. For these and other reasons, filoviruses are classified as category A biological weapons. However, there is very little data from animal studies with aerosolized filoviruses. Animal models of filovirus exposure are not well characterized, and there are discrepancies between these models and what has been observed in human outbreaks. Building on published results from aerosol studies, as well as a review of the history, epidemiology, and disease course of naturally occurring outbreaks, we offer an aerobiologist's perspective on the threat posed by aerosolized filoviruses."

or

Our study has shown that Lake Victoria marburgvirus (MARV) and Zaire ebolavirus (ZEBOV) can survive for long periods in different liquid media and can also be recovered from plastic and glass surfaces at low temperatures for over 3 weeks. The decay rates of ZEBOV and Reston ebolavirus (REBOV) plus MARV within a dynamic aerosol were calculated. ZEBOV and MARV had similar decay rates, whilst REBOV showed significantly better survival within an aerosol."

Reston is not Ebola, but a close relative.

[hackuser]

What you posted is from good sources and is interesting, but I'm not sure it's conclusive or helps. They are two studies/reports of possibly many and I don't know their credibility or if they represent consensus or fringe, good science or bad. Also, they require expertise to interpret and draw conclusions from.

We're not qualified to perform our own analysis; what we need are conclusive analyses from experts about the scientific consensus and range of possibilities.

[bradleyland]

So we should all be quiet and listen for the experts to give us guidance? Sounds like the antithesis of hacker culture to me. It also sounds like horribly bad advice based on large establishments' historical propensity (categorically) to act from what they know, fail to react to changing environments, and cover up what might make them look bad.

Yes, this is all dangerous thinking. Yes, this is acting from one's gut, rather than waiting on the data. But when it's my life on the line, I'm going to err on the side of caution. When death is on the other side of the decision, I'm going to be a little more skeptical of other people's certainty.

[adventured]

These credible professionals certainly seem to think ebola can infect via aerosol, and perhaps remain in the air for up to an hour:

http://www.cidrap.umn.edu/news-perspective/2014/09/commentar...

I have to believe the US Government already knows that ebola is capable of this, they've been studying it for decades. If it can spread by aerosol, they're lying to prevent substantially more panic.

Downvoters should start by refuting the linked article - it's a pretty important article. The authors are guaranteed to know a lot more about ebola than anyone here.

[maxerickson]

Why not seal off the apartment? There's pretty much no downside, so I don't think it really says much (especially assuming ~2 people regularly use it...).

[blisterpeanuts]

Cold comfort if he has created a public health crisis in the city. He should have self-quarantined upon his return, in my opinion.

[bjz_]

Agreed. He might have been silly for being out in public right after having come back from Africa, but I'm sure he did more good over there in preventing the spread of the disease (which helps us), than he might have done when coming home. Lets hope future doctors learn from this.

[jeffdavis]

"I'm sure he did more good over there in preventing the spread of the disease"

Why are you sure?