Hospice Patients Alliance: Patient Advocates

Reality Check -- Ebola 2014

by Ron Panzer

October 22, 2014

Precautionary Measures

I was trained as a boy scout -- as were so many others in this country. If you also were a boy or girl scout, or were trained by your own family members, you are likely to know how to start a fire using not only matches, but also by striking a flint stone with a steel bar to create a spark.

We know that there are several factors to be considered in starting a fire responsibly: choosing and setting up the campfire site, choosing the materials to burn and choosing how to arrange those materials before starting the fire.

How do we start? We choose the site making sure it will be dry and protected from wind, yet far enough from any branches or vegetation that might catch fire. We make sure there is readily combustible material ("tinder") to use as fuel for the first phase of the fire and place that at the center. We then place small twigs, often in a tee-pee or square framework around the tinder. If you've used flint and steel, you know that the first spark doesn't always catch and you have to strike several times till the tinder is lit. You may have to blow on the tiniest of burning embers to get the fire to catch and burn well. Under some circumstances, starting a fire takes a lot of effort!

Even if you have matches, the fire doesn't always keep burning. It may fail for several reasons. The wood may not be dry enough. The wind may blow the tiny fire out. Rain may drown that fire or you might have positioned wood that is too large in diameter to catch fire quickly. An experienced camper knows how to avoid these problems and can usually get a fire started without difficulty.

One more thing: when you start a fire, you make sure to keep everyone safe, and you don't stop making sure everybody's safe. You consider those who will be near the fire while it's lit, and you take steps to make sure the fire is completely extinguished once you're done. You think about anyone or anything that might be harmed later on as well.

Scouts and firefighters know these things, but firefighters look at the creation of fire from a totally different perspective than many campers. According to the National Interagency Fire Center, in 2013, 47,579 separate wildfires burnt over 4 million acres of forested land, taking homes and businesses with them.1 In 2013, 97 firefighters died;2 thousands of others lose their lives each year in the U.S.A.3

When we are confronted with the possibility of wildfires in our own region and home towns, or when we are confronted with any other threat to life or our health, any sane and well-informed individual will take steps to avoid or minimize those threats and prevent harm. When undertaking any activity at all, any sane individual will take steps to avoid conditions which can give rise to threats to life and the health of the residents in the community.

We consider not only the present, but also the effect our actions will have on future generations. This is the essence of the Precautionary Principle.4 It means we pay attention to the all the details and that we consider all the implications of our actions. We think about the results of our actions and how they would impact all of us.

At a governmental level, competent leaders will do the same and move forward to further the success of the mission at hand and help the people prosper while choosing actions that avoid harmful consequences. Even then, unanticipated problems will arise. The resourceful leader will, again, make choices to resolve those problems and get back on track.

Just as wildfires may arise through natural causes such as lightning strikes or may be intentionally set by arsonists, problems in our world may arise naturally or due to collective or individual actions. Once wildfires start, and once problems arise, well-intentioned individuals will try to stop them as soon as possible while they are small, easily contained and resolved.

Wildfires may take a few thousand lives in the U.S. annually. With a mortality rate in the 70% range, the 2014 Ebola Virus pandemic is likely to take the lives of millions around the globe before its spread is halted. If it remains true to its historical pattern, those 70% in a region who are those taken by the disease, will die, and only 30% will survive. In other words, the disease spreads everywhere unchecked and then "burns itself out" having taken the lives of those it could take. Whether it takes more than just a few lives in the U.S. is in the hands of our leaders who can put a stop to the entry into this country of anyone infected with ebola.

Stopping the spread of this very lethal disease is without any doubt of the highest importance. With that in mind, we know that when problems or threats to life are intentionally created, when the risk of contracting ebola is intentionally increased unnecessarily, we can know that evil is at work. While "evil" is a word that is avoided in the mainstream secular society, avoiding the use of the word has never negated the reality of its existence. Choosing to intentionally increase the exposure of Americans to the disease is wrong.

Like so many others who were raised in a secular household, it took me a long time to realize that evil exists and that some can intend evil. I was very na?ve and did not wish to believe anyone would intentionally harm others. I was taught to believe that if someone did harm others, there was an explanation that might justify their actions or explain it away, such as "mental illness," poverty, and so on. The idea of evil itself did not enter the discussion.

But I've been compelled to accept the reality of both good and evil, experiencing both in my life and in the lives of so many around the world. There is no doubt that leaders who knowingly take steps that are certain to cause harm to those in the community they are sworn to protect are not honest, not well-intentioned, and certainly influenced by evil.

Of course, in a secular society, we're not supposed to be "judgmental," and therefore, we're supposed to accept almost all behaviors and actions without question. I learned that this demand is also a perversion of the truth. We may not know everything about others and because we are imperfect as well, we should not judge others as a person, but that does not mean we should refrain from judging their actions and behaviors just as we do our own. We must do so in order to survive in this world and protect ourselves and those around us from harm! In fact, if we are honest with ourselves, we realize that we and everyone else in the world do this all the time.

Yet, many of us stand back and watch what is happening in our world and assume, or hope, that our leaders make decisions based upon our best interests. Others observe our leaders' actions and see that our best interests are not being advanced or protected at all!

Ebola: Transmitted Mainly through Direct Contact

Anyone who's been paying attention to the news is quite concerned about the current outbreak of the "Zaire-type" ebola virus in W. African nations such as Liberia, Sierra Leone, and Guinea. They are also extremely concerned about the spread of this ebola to America when ebola-infected Thomas Eric Duncan arrived in Dallas, Texas. After two nurses subsequently became infected after caring for him, the level of concern rose to alarm if not complete panic.

In the W. African nations of Liberia, Guinea, and Sierra Leone, there is real panic, along with rioting, and the need for a strong military and police presence on the streets to control the people so that ebola does not spread even more. Due to the traditional practices of the people, such as butchering and eating "bush meat" from ebola-infected fruit bats and monkeys, thousands of people have contracted the disease and about 70% of them have died.

Due to the traditional practices of the people, including washing the dead ebola-infected bodies of their loved ones, without any protective equipment or precautions, and not properly disposing of infected materials, the disease is spreading like a wildfire in these countries. The disease is truly completely out-of-control in these nations, especially Liberia.

By closing their borders, preventing those who were infected from entering, other nations have prevented the spread of ebola into their populations. If ebola virus spreads to other W. African nations and from there to large nations such as India or others in Asia where there is little healthcare for many millions of people, the world could be facing a truly global pandemic threatening the lives of many millions. This is the outcome that is most feared by those contemplating the spread of this lethal disease.

On the other hand, Nigeria did not close its borders, but made a massive effort to isolate those patients who were identified and treat them in specialized ebola treatment centers, track down and quarantine those who had been exposed, and monitor them, making sure they also were either treated or determined to be ebola-free. By keeping their borders open, knowing ebola had already entered the nation, Nigerian officials reassured the people and lessened any sense of panic that might have arisen.

The Liberian national, Thomas Duncan, flew from Liberia to the United States having formally denied the fact that he actually did have direct contact with a severely infected ebola patient there. He was therefore allowed to leave Liberia and fly to the United States where he subsequently began demonstrating one of the first signs of ebola virus disease: a fever. When he first entered the hospital emergency room in Texas, he did not tell the doctors that he likely had contracted the ebola virus, though he must have known! He had a fever, but was eventually sent home. Some blame the hospital for sending him home, but did they know he had been exposed to ebola?

However, when Mr. Duncan returned to the hospital, he was placed in the emergency room without isolation or quarantine and left there for hours. At that point, he was known to have come from Liberia, to have severe vomiting along with high fever, both signs of active ebola virus disease. Although such a patient had never been handled in such an American hospital, the news about the ebola epidemic in W. Africa was well-known and must have been known to the hospital's administrators.

The Texas Health Presbyterian Hospital is a major regional hospital with approximately 900 beds and over 1,000 physicians involved in patient treatment. When a major regional medical center can get it so wrong, we ask, "What will happen at smaller hospitals or other regional hospitals around the country if they get an ebola case?" It really is quite surprising that protocols for handling an ebola patient had not been properly put in place.

It is also disturbing that once the hospital knew he was a likely ebola patient, proper protective gear was actually not provided and proper protocols for handling an ebola patient were not observed. It is extremely fortunate that other patients and staff (besides the two who subsequently did become infected) did not acquire the disease.

The protocols for handling ebola patients are not a mystery, and have been known for many years, even though the hospitals and the government officials have given the impression that these protocols have not existed beforehand: they have! The conflicting statements made about what the proper protocols are is symptomatic of a politicized public health effort that has failed to state the facts from the beginning.

Of course, lessons have been learned from the mistakes of the Texas hospital administration and the U.S. Centers for Disease Control & Prevention ("CDC"). One of several problems is the changing public messages about the protocols being recommended by the CDC and the contradictions between what CDC staff do when handling ebola virus in the laboratory and what healthcare staff are expected to use when exposed to actual patients with much higher quantities of ebola virus.

Ebola: Capable of being Transmitted to those nearby through Aerosolized Droplets in the Air

To get a reality check, we can consult the 2011 version of the U.S. Army's handbook on infectious diseases. Ebola virus is categorized within the filoviridae family of Viral Hemorrhagic Fevers ("VHF") viruses. The handbook states:

"All VHF patients should be cared for under strict contact precautions, including hand hygiene double gloves, gowns, shoe and leg coverings, and face shield or goggles. Airborne precautions should be instituted to the maximum extent possible and especially for procedures that induce aerosols (e.g., bronchoscopy). At a minimum, a fit-tested, HEPA filter-equipped respirator (such as an N-95 mask), a battery-powered, air-purifying respirator (PAPR), or a positive pressure-supplied air respirator should be worn by personnel sharing an enclosed space with or coming within 6 feet of a VHF patient. Multiple patients should stay in a separate building or a ward with an isolated air-handling system when feasible. Ideally, VHF patients should be isolated in a negative-pressure isolation room with 6-12 air exchanges per h[r]. Environmental decontamination is accomplished with hypochlorite or phenolic disinfectants."5

Notice the Army's attention given to instituting airborne precautions to prevent the transmission of ebola through ebola-laden droplets in the air, whether from a cough or something that "aerosolizes" the droplets and makes it travel further through the air. The Army is certainly not going to recommend preventive measures that are not necessary!

The reality is that contrary to the impression being given, through droplet-exposure, ebola is transmissible through the air, most likely within a three-foot radius, even though technically it is not a completely "airborne" illness. It's not going to travel hundreds of feet through the air or through a ventilation system as some truly "airborne" diseases like tuberculosis, measles or chickenpox do, but droplets containing ebola virus, even tiny droplets, can travel through the air when someone coughs or sneezes. If droplets might carry ebola to those nearby through the air, you and I don't wish to breathe that in, so we take steps to stop that: highly specialized respirators, not a simple mask. We have a separate air supply so we don't breathe from the patient care area.

The main understanding being communicated to the public about ebola has been the well-established fact that "ebola virus can be transmitted by direct contact with blood, body fluids, or skin of EVD patients or persons who have died of EVD."6 But as we have seen, that is not the entire story. It's clear from the Army's protocol that does involve airborne precautions even if ebola is not a technically "airborne virus!"

The World Health Organization ("WHO") also states:

"Ebola virus disease is not an airborne infection. Airborne spread among humans implies inhalation of an infectious dose of virus from a suspended cloud of small dried droplets. This mode of transmission has not been observed during extensive studies of the Ebola virus over several decades.

Common sense and observation tell us that spread of the virus via coughing or sneezing is rare, if it happens at all. Epidemiological data emerging from the outbreak are not consistent with the pattern of spread seen with airborne viruses, like those that cause measles and chickenpox, or the airborne bacterium that causes tuberculosis.

Theoretically, wet and bigger droplets from a heavily infected individual, who has respiratory symptoms caused by other conditions or who vomits violently, could transmit the virus - over a short distance - to another nearby person.

This could happen when virus-laden heavy droplets are directly propelled, by coughing or sneezing (which does not mean airborne transmission) onto the mucus membranes or skin with cuts or abrasions of another person.

WHO is not aware of any studies that actually document this mode of transmission."7

That being said over and over again by so many, the question of very likely airborne transmission was demonstrated by Drs. Jaax, et. al., from infected monkeys to healthy monkeys kept 10 feet away. How did the healthy monkeys become infected if not through the air?

"We report transmission of Ebola virus (Zaire strain) to two of three control rhesus monkeys (Macaca mulatta) that did not have direct contact with experimentally inoculated monkeys held in the same room. The two control monkeys died from Ebola virus infections at 10 and 11 days after the last experimentally inoculated monkey had died. The most likely route of infection of the control monkeys was aerosol, oral, or conjunctival exposure to virus-laden droplets secreted or excreted from the experimentally inoculated monkeys.8

Another experiment demonstrated very likely pig to macaque monkey airborne transmission without any direct contact when kept in the same room. There was no direct physical contact between the pigs and the monkeys, yet the monkeys still contracted ebola. How do you explain that if there is no airborne transmission? On the other hand, human to human transmission of this sort has not been proved in an official study, but that doesn't mean it cannot happen or hasn't happened.9

It may be that the greatest scientists and medical researchers of our time simply do not know everything there is to know about ebola. When there is doubt about how ebola might be spread, even a miniscule doubt, we must err on the side of caution to save lives! Isn't that what you would do to protect your loved ones?

When the disease has progressed to showing symptoms and the patient's "viral load" is high, it is much easier for the patient to transmit the disease to others, and even a tiny exposure can cause infection and death shortly thereafter. Whether a person survives, depends upon the supportive care they receive and their own body's capability to fight off the disease.

That is the exact point when nurses, doctors and other healthcare workers actually begin interacting with and caring for the patient. Nurses especially are less than 3 feet away from the patient; they are directly contacting, touching the patient and dealing with several bodily fluids. How would you like to be a dentist who is working on a patient who does not show signs of ebola but actually has the disease? Not all patients exhibit the same outer signs of disease. Exposure to blood is very possible in dentistry or in other healthcare settings — when drawing blood for testing, for example.

Healthcare workers need the highest level protection - just as the U.S. Army manual demands. Close immediate family members are also at high risk if they are living with someone who has active ebola disease. That is why patients must be kept in isolation from others.

In the case of ebola, just as wildfires begin with little fires, so seemingly insignificant details matter. Discipline, attention to detail, striving for perfection in what we do ... these all matter. Striving for perfection in what we do in preventing the spread of ebola, or any threat to well-being and lives, is urgently needed. Yet, we have seen misstep after misstep in how cases have been handled in the U.S.

On September 17, 2014, Drs. Brosseau and Jones, national experts on respiratory protection and infectious disease transmission from the University of Illinois at Chicago, suggested that current precautionary measures and understandings related to the prevention of ebola transmission in healthcare settings are outdated and inadequate. They state:

"The precautionary principle-that any action designed to reduce risk should not await scientific certainty-compels the use of respiratory protection for a pathogen like Ebola virus that has:  
  • No proven pre- or post-exposure treatment modalities
  • A high case-fatality rate
  • Unclear modes of transmission

We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks [emphasis added].

The minimum level of protection in high-risk settings should be a respirator with an assigned protection factor greater than 10. A powered air-purifying respirator (PAPR) with a hood or helmet offers many advantages over an N95 filtering facepiece or similar respirator, being more protective, comfortable, and cost-effective in the long run.

We strongly urge the US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) to seek funds for the purchase and transport of PAPRs to all healthcare workers currently fighting the battle against Ebola throughout Africa-and beyond.

There has been a lot of on-line and published controversy about whether Ebola virus can be transmitted via aerosols. Most scientific and medical personnel, along with public health organizations, have been unequivocal in their statements that Ebola can be transmitted only by direct contact with virus-laden fluids and that the only modes of transmission we should be concerned with are those termed "droplet" and "contact."

These statements are based on two lines of reasoning. The first is that no one located at a distance from an infected individual has contracted the disease, or the converse, every person infected has had (or must have had) "direct" contact with the body fluids of an infected person.

This reflects an incorrect and outmoded understanding of infectious aerosols, which has been institutionalized in policies, language, culture, and approaches to infection control.10

All of us have the right to know the truth. Don't we? How else can we prepare for what is to come or, for what confronts us at this very moment? Even if science does not have all the answers yet, we still have a right to know about possible means of ebola transmission and the likely means of protecting ourselves and those around us from infection.

Public Health Measures

Of course, people naturally have good reason to be afraid. Although modern medical science offers no established cure for ebola virus, and can only offer supportive treatment to help a patient survive, new vaccines are currently being developed that could help in the months ahead. There also have been anecdotal experimental efforts that have succeeded. Dr. Gabriel Gorbee Logan is using lamivudine, an anti retro virus drug also used to treat HIV patients and has had good results when patients are treated early on in the ebola disease progression. "Dr. Anthony Fauci, Director of the [U.S.] National Institute of Allergy and Infectious Diseases gave thumbs up to Dr. Logan's method because Lamivudine is a nucleotide analog, and other drugs in this class are being studied to treat Ebola."11

In past epidemics in Africa, 25-90% of those infected died. It is really not known what percentage of ebola-infected patients will die if given supportive modern medical treatment, but the current fatality rate in Africa is estimated to be about 71%.12 Think about that: ten people in a room and seven of them die!

In the past, ebola outbreaks in Africa arose in remote villages after villagers captured, butchered and consumed fruit bats, monkeys, and other "bush" animals. The epidemics "burned themselves out" when almost everybody died. This year, the epidemic spread to cities in the W. African nations resulting in the deaths of thousands there, and from Africa to other nations including Spain and the United States with just a few cases.

We hope to limit the number of cases, and certainly do not wish to facilitate the creation of even more cases. Right?

We know that with just one flight from Africa to any nation including the U.S., ebola could spread. Many are concerned since individuals in the early stages of the illness might exhibit no signs that they are carrying the ebola virus, and even if they have a fever, they can suppress the temperature with medications like Tylenol or Motrin.

So, many of us do not trust what we are being told by government leaders, whether from the United States or other nations or the World Health Organization. Many of us do not believe adequate preventive measures are being taken at all.

News outlets regurgitate the talking points given to them by the officials in government supposedly to give "the facts" to the public. Yet, sometimes "the facts" change over time, and when that occurs, it becomes apparent that false information had earlier been given.

Many are concerned and quite upset that our current leaders have chosen not to prevent entry into our nation by individuals who come from ebola-ridden W. African nations like Liberia, Sierra Leone, and Guinea. They have stated that it would be "too difficult" or would not accomplish anything. This stance is completely contrary to long-established basic principles of public health! The U.S. CDC provides the following explanation of quarantine protocols:

Quarantine and Isolation

"Isolation and quarantine help protect the public by preventing exposure to people who have or may have a contagious disease.

Isolation separates sick people with a contagious disease from people who are not sick.

Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.

Twenty U.S. Quarantine Stations, located at ports of entry and land border crossings, use these public health practices as part of a comprehensive Quarantine System that serves to limit the introduction of infectious diseases into the United States and to prevent their spread.13

Isn't that "common" sense? We prevent exposure and transmission by isolating and quarantining those exposed to this extremely lethal disease.

If, as many government leaders have stated, blocking the entry of individuals coming from ebola-ridden countries serves no purpose, why would there be twenty U.S. quarantine stations located at ports of entry and land border crossings into our nation? What is their purpose and when would we actually use them, if not with a lethal disease like ebola virus? Obviously, quarantining those who might have been exposed to ebola virus is the common sense approach to prevent its spread to the U.S.

What are the purposes of the U.S. quarantine stations if they are never used? For that matter, what was the purpose of the Ellis Island quarantine stations and what was the government thinking way back then? They quarantined legal immigrants who were ill back then. They didn't release them into the general public until they were tested and determined to be healthy.

All it would take is a government statement informing the airlines and other nations that nobody coming from those ebola-affected nations will be permitted to enter the U.S. at all or nobody would be permitted entry unless they undergo a quarantine period in strict isolation before arriving here. Border agents could stop them at the border crossings if the leader of our nation had the intent and will to do so. Many African nations have done so. Russia will close its borders on October 31st. Other nations will also do so. Why aren't we?

Some leaders have stated that closing down air travel to or from those nations would hurt in the end because supplies and aid could not reach the affected African nations, allowing for the ebola epidemic to only get worse. Of course, that is nonsense. Charter or military flights could be allowed to send supplies and relief personnel to the affected region while preventing individuals to travel from that area and spread the disease.

Because ebola is so deadly and death comes quickly to those who succumb, and because it only takes a tiny bit of ebola virus to transmit the disease, it makes sense to prevent the wildfire-like spread of the disease into completely untouched nations, and if there is a tiny outbreak, like a small spark, you extinguish that tiny outbreak before it grows into something uncontrollable.

When you wish to eradicate a disease, the rate of transmission must be reduced to less than one and certainly must not be anything more than one. Right now, the disease is doubling every 3-4 weeks, meaning that the number of cases is growing exponentially:

Graph from: "4000 Deaths And Counting: The Ebola Epidemic In 4 Charts" by JV Chamary, October 13, 2014, Forbes.com 14

It is evident that if the spread is not stopped, the number of individuals infected will reach into the millions. If the disease spreads to nations like India or other nations where large numbers of the poor have little to no access to modern, supportive care and little ability to isolate those individuals, the disease will take the lives of many millions.

Based upon current reports from the field in Africa, the U.S. CDC professionals estimate that there will be over 500,000 cases in Africa by January 2015. It is likely that there will be many more than that since reports significantly underestimate how many cases there already are. The total death rate is realistically very likely to reach into the millions!

Stopping that transmission to healthy individuals is paramount. Questions as to how to accomplish that abound. Are ordinary preventive measures adequate to stop the spread of this disease? Clearly not! When physicians like Dr. Kent Brantly, who is known for his extremely meticulous practice of disease preventive and precautionary measures, nevertheless contracted the disease, the extreme contagiousness of the disease is demonstrated.

During the Middle Ages, the plague, now known to be caused by the bacterium Yersinia pestis and transmitted to humans through infected fleas, took the lives of hundreds of millions of people, completely devastating entire regions of the globe. The people had no understanding how the disease was spread, and therefore were defenseless against its spread.

We now know that there are three types of plague: the first is known as bubonic plague and initially affects the lymph system. It is transmitted with a flea bite or direct contact with someone who has the disease. "Pneumonic plague, the second form, is transmitted through infected droplets in a sick person's cough." The third form is septicemic plague and arises from either bubonic or pneumonic plague, and occurs when the bacteria multiply and enter the bloodstream.

A modern pandemic of plague struck all around the world from the 1860s through the early 1900s, and "caused approximately 10 million deaths (Khan, 2004)." 15 The last urban epidemic of plague struck in Los Angeles from 1924-1925, although a trickle of cases has continued to the present time. Plague is very easily treated today with commonly available antibiotics. 16 Ebola is not!

Even though there are no studies to prove that ebola virus disease is spread through inhaled aerosolized droplets spread around when someone coughs or sneezes, every expert admits that it is possible if the transmission occurs when an infected patient is in close proximity to another individual. That is exactly where healthcare workers spend their time!

During the Middle Ages and as recently as the early 1900s, bubonic plague spread through direct contact (as well as a flea bite) while pneumonic plague spread through droplet-transmission to those nearby through the air (even though not technically "airborne" transmission. That is exactly the potential forms of transmission involved with the transmission of ebola virus! The lethality of the plague during the Middle Ages (when there was no cure) is similar to the lethality of ebola today, even with modern supportive treatments.

Newscasters have clearly been paid to and instructed to minimize the threat. They have made some amazing statements like, "Flu causes several thousands of deaths each year," and "We only have two new cases of ebola in the U.S." Right. First of all, the "thousands of deaths" due to influenza are estimates and actual proved cases number only in the hundreds annually. Secondly, the potential spread of ebola in the U.S. or around the world, is in the many, many thousands, if not millions, should it take hold in our cities, especially densely populated areas of our cities. Horribly, in Liberia, 7 out of 10 are very, very likely to die! This is nothing like the modern day flu.

When there's a wildfire, nobody knows how much of the forest will burn or which homes will be destroyed. A little spark here -- a little spark there -- and nobody knows who and how many will die. For so many reasons, the most basic public health measures demand that we prevent the spread before it becomes that "wildfire" many fear. Some will make "educated guesses," much like weathermen predicting a 50% chance of storms. Sometimes, we just do not know.

So it is with ebola -- as it was with other deadly illnesses in the past. When modern medicine has no cure for the current epidemic of ebola with its yet to-be-determined number of deaths, we must take proper steps to protect the citizens of the nation as well as all healthcare workers. We really do not know exactly what would happen if a widespread ebola outbreak occurred in a modern, industrialized society.

It would certainly overwhelm the healthcare resources at hand and it will humble the arrogance of physicians and scientists who have assumed they had "everything" under control. Almost all hospitals in the country are truly not prepared to handle ebola cases! Even a few more cases in the U.S. would certainly cause widespread panic and rioting in some locations.

In the U.S. and other Western nations, there is a little fire. We don't need a wildfire like the one raging in West Africa. Historically, the first principle of public health promotion is that you prevent entry into an unaffected area of any infected individuals. To do otherwise is utterly wrong! Only an enemy of the nation would encourage entry into the nation of those who may be infected by such a lethal disease!

Yet, what will happen after the 4,000 U.S. military personnel already sent to W. Africa, along with the newly called-up National Guard troops the leader is sending to W. Africa, come home after working with blood specimens of ebola patients or knowingly or unknowingly coming into contact with actively-infected ebola patients? It is extremely likely that some of those soldiers will come home infected with ebola. We will learn whether or not they do acquire the disease in the next several months. If they do, will they be kept in a military base in Germany for healthcare before returning to the U.S.? Or, will they come directly home to areas all over the nation, possibly seeding the nation with ebola? 17

The idea of intentionally "seeding" the nation with ebola might sound completely unbelievable to many. Yet, for those who have been paying attention, the administration has intentionally facilitated the entry into our nation of tens of thousands of illegal immigrants into the country, mostly from Central America, and sent those individuals to almost every state in the nation without quarantining those who had signs of illness or making sure they were healthy before sending them around the country!

Although the administration forbade healthcare workers and border agents from publicly disclosing the diseased condition of many of the illegal immigrants who recently entered our nation, due to a few brave whistleblowers, it is now known that many of the illegal immigrants are infected with antibiotic-resistant tuberculosis, MRSA, chickenpox, swine flu, chagas disease, scabies, enterovirus, even leprosy, and other illnesses.18 Many of these children are entering the public school systems all over the country. Information about the health status of these children and the adults is being suppressed by the national media and the current administration.

What would be the reason to allow and actually encourage such illegal entry into our nation? What would be the purpose of sending ailing children and adults all over the nation without first treating their diseases? The overloading of the healthcare system, educational system and other aspects of our society to the point of societal chaos, rioting and anarchy so that the government is called upon to take control in a top-down, totalitarian way to handle extreme crises.

This has been termed the "Cloward-Piven" strategy studied by the leader of our nation at Columbia University. It states that one should "overwhelm the system and bring about the fall of capitalism by overloading the government bureaucracy with impossible demands and bring on economic collapse."

That anyone would intentionally do such a thing is mind-boggling to the naive majority of Americans. However, doing anything possible to rid the U.S. of capitalism and form a socialist government and economy is a given among the communists who now call themselves "progressives." Their slogan all around the world is "Forward," just as the leader of our nation used that slogan during his campaigns.19

We must remember that as goes the healthcare system, so goes the nation. The leader has acknowledged the ultimate goal of the Affordable Care Act ("Obamacare") is to lead as an intermediate step toward single-payer, government-controlled healthcare, i.e., socialized medicine. It should also be understood that virtually every close advisor, appointed Cabinet member, or historical associates of the leader are known communists. His mentor, Frank Davis was a card-carrying communist. His mother and Kenyan father (Obama) were socialists. Bill Ayers, whose home the leader used to launch his Presidential campaign, is a well-known unarrested terrorist and communist.20

What appears "insane," or incomprehensible to many, is the step-by-step implementation of a plan to fundamentally change America, destroy its capitalist economic system, and substitute a completely socialist economy and a totalitarian government: one party rule. Flooding the nation with illegal immigrants, many of whom will vote for the political party that will provide free healthcare, free food, free education, etc. will result in control of the entire government for generations.21

While some may ridicule such a theory, stating that the Republicans are likely to take the Senate in 2014 and hold control of the House of Representatives, that may be a merely temporary victory for them. We have to look at the overall trending picture of the U.S. population. Presidential elections are completely different things than mid-term elections involving Congressional and state elections. Should a significant portion of illegals, even a few million, be granted citizenship one way or another, the nation would irrevocably swing towards one-party Democrat rule for generations.

Unfortunately, even according to Democrat party members, the party leadership has swung far to the Left along with its "Alinskyites," and its goals are indiscernible from the goals of the communist party's goals.22 Look it up. You'll see.

In almost every communist takeover of a nation, abortion is legalized and made readily available to, or even forced upon, women. Homeschooling is forbidden. Religious expression is severely curtailed, if allowed at all. Free-enterprise is limited and highly controlled by government regulation. The possibility for individual economic advancement is eliminated. Freedom of assembly and expression, especially political protest is nonexistent. The government bureaucracy, police and military are all used to discourage or destroy the political opposition. Allegiance to government, the "state," is placed over and above loyalty to family. Parental rights are minimized. Sound familiar?

Hardly "incompetent" as many deem him, the leader is one-pointedly moving toward his goal of transforming the nation. The leader has used, and will use, every opportunity to advance his agenda. Using ebola as a crisis to further his goals is truly obscene and evil, but I, as many also have done, have seen clearly that the leader does not care about the suffering his policies have already caused to many. Whether people lose their jobs or their lives matters nothing, so long as the change he hoped for is achieved: a socialist U.S.A.

When a leader completely ignores much of the Constitution governing the nation, there can be no doubt he really does not care. Our leader is the most anti-American, anti-life, anti-traditional family values, anti-natural marriage between a man and a woman, anti-God, anti-Constitution, and pro-abortion President who has ever occupied the office. As an extreme understatement, he lies frequently about the most important things.23

The President is the one who Constitutionally is vested with the power to lead the nation and protect its citizens from any threat, foreign or domestic, especially threats from violence or disease. To date, he has utterly failed to lead and failed to protect the healthcare workers throughout the nation. We must ask, why do those who experiment in the lab with Ebola virus use Biosafety Level 4 protective measures? Level 4 is the highest level of precautionary measures and a whole-body suit along with a separate air supply is provided for anyone working with Ebola in the lab so they do not breathe in any air from the room containing Ebola.

The U.S. CDC states this very plainly on their own website. The CDC's "Viral Special Pathogens Branch" ('VSPB') is the department that works with Ebola virus and other pathogens.

"The Viral Special Pathogens Branch's (VSPB) charter is the study of highly infectious viruses, many of which cause hemorrhagic manifestations in humans. Our daily work involves the investigation of viruses of Ebolavirus, Marburgvirus, Lassa fever virus, Rift Valley fever virus, Crimean-Congo hemorrhagic fever virus, other Arenavirus and Hantavirus species, and additional recently identified and emerging viral species.

Almost all of these viruses are classified as Biosafety Level 4 (BSL-4) pathogens and as such must be handled in special facilities designed to contain them safely. VSPB operates one of the world's few BSL-4 laboratories."24

Reality check: globally, over 200 highly-trained healthcare workers have died after contracting the ebola virus in 2014. Many of these were extremely knowledgeable about preventive measures to be followed when dealing with ebola, but remember, healthcare workers often work at a distance of zero, not even the much-cited "three feet" distance from the patient. They are involved in direct care, touching and moving the patient and handling patients' bodily fluids.

So, when experts say, "It's very hard to get ebola," they're simply attempting to prevent panic. They are not speaking the truth. The reality is that if you're actually working with ebola patients or living in an area overridden with ebola, it is very hard to prevent transmission and it takes extreme caution to work safely under those conditions. Anyone who really believes it's "hard" to get ebola is welcome to take a trip to the West African nation of Liberia and live there for a few months and then they can report back to us!

Quarantine and isolation are the most effective means to prevent transmission to areas that are not affected. That is why a travel ban or mandatory quarantines and isolation measures are necessary.

For healthcare workers that must treat ebola patients, specialized equipment including whole body suits, highly specialized respirators, and controlled air flow are necessary. Hospitals should be building facilities that can provide Biosafety Level 4 preventive measures. At a minimum, every state should have a regional facility specialized in handling such cases. No healthcare worker should have to care for an ebola patient without the essential Biosafety Level 4 equipment and air-handling environment. In fact, healthcare workers should demand such equipment be provided.

Although I am not a member of a union, the National Nurses Union demands for several essential measures to protect healthcare workers are exactly what is needed. Some of these are:

  • The employer shall provide optimal protocols and personal protective equipment for Ebola that meets the highest standards used by the University of Nebraska [which are Biosafety Level 4 protocols and personal protective equipment] including:

    1. Full-body hazmat suits that meet the American Society for Testing and Materials (ASTM) F1670 standard for blood penetration, the ASTM F1671 standard for viral penetration, and that leave no skin exposed or unprotected and
    2. National Institute for Occupational Safety and Health-approved powered air purifying respirators with an assigned protection factor of at least 50.

  • There will be continuous interactive training with the RNs who are exposed to patients. There will also be continuous updated training and education for all RNs that is responsive to the changing nature of disease. This would entail continuous interactive training and expertise from facilities where state of the art disease containment is occurring.

  • The employer shall adhere to precautions and protections based on the precautionary principle.

  • An RN has the right to refuse to care for an Ebola patient if, in the RN?s judgment, the conditions are unsafe.

  • There shall be at least two RNs caring for each Ebola patient with additional RNs added as needed based on direct-care RN judgment and they shall not have other patient assignments.

  • If the Employer has a program with standards that exceed those used by the University of Nebraska, the higher standard shall be used.25

These and other protective measures and processes are essential to the integrity of our healthcare system and the safety of all healthcare workers. Whether registered nurses, physicians, or any other healthcare workers serving ebola patients, all must have adequate measures in place to assure their safety. Remember, if the front-line healthcare workers die, as many have in W. Africa, there will not be a healthcare system for the rest of us. Chaos would result and must be prevented.

As of October 20, 2014, the CDC has revised its recommendations and now admits that a full body suit and a "powered air-purifying respirator (PAPR) or an N95 or higher respirator in the event of an unexpected aerosol-generating procedure,"26 should be provided to and used by healthcare workers serving ebola patients. They are still not requiring proper air-handling mechanisms as in true Biosafety Level 4 facilities (such as exist in only a very few facilities in the entire nation). Ebola patients are most safely served in a separate facility with that specialized air-handling capability!

Even then, the revised CDC recommendations are closer to what Biosafety Level 4 precautions require. Unfortunately, these recommendations are merely that: recommendations. Will all hospitals make the effort to obtain such equipment and actually supply their staff with this equipment? Will they train their staff in donning and removing the full body suits and respirators? Can we count on hospital administrators throughout the country to make the right decision if it means they need to spend the funds to adequately protect the workers? Will the governors in each state set up regional biosafety level 4 ebola treatment units? Such facilities would also be capable of handling patients infected with other highly contagious and dangerous infections.

In any case, it is the President who has the authority and duty to act (through the Dept of Health & Human Services) to mandate that the biosafety level 4 protocols be followed. This is one of the few situations where the President actually should use his executive authority to order that the protocol for preventing transmission of ebola disease be followed. If he does not do so in this case, even though he has used his executive authority in many other questionable areas, the deaths of any healthcare workers who succumb to this disease after not being provided such protective equipment, will be due to his inaction. Their blood will on his hands.27


 1.    National Interagency Fire Center, "National Interagency Fire Center Statistics," Accessed Oct 2014. Back

 2.    R Fahy, et. al., "Firefighter Fatalities in the United States - 2013," June 2014, National Fire Protection Association,
            Fire Analysis and Research Division. Back

 3.    U.S. Fire Administration, "U.S. Fire Statistics," accessed Oct 2014 Back

 4.    Ron Panzer, "Man in the World - Part Six, The Precautionary Principle,"
            Restoring the Culture of Life, April 17, 2013, Hospice Patients Alliance. Back

 5.    U.S. Army, "Medical Management of Biological Casualties Handbook - 7th Edition," Sept 2011,
            United States Army Medical Research Institute of Infectious Diseases. Back

 6.    SF Dowell, et.al., Transmission of Ebola hemorrhagic fever: a study of risk factors in family members,
            Kikwit, Democratic Republic of the Congo, 1995. Commission de Lutte contre les Epidemies a Kikwit.
            The Journal of Infectious Diseases. Feb 1999;179 Suppl 1:S87-91. (cited at CDC) Back

 7.    World Health Organization, What we know about transmission of the Ebola virus among humans,
            Ebola situation assessment - Oct 6, 2014, WHO. Back

 8.    N. Jaax DVM, et.al., Transmission of Ebola virus (Zaire strain) to uninfected control monkeys in a biocontainment laboratory,
            The Lancet - December 30, 1995 ( Vol. 346, Issue 8991, Pages 1669-1671 ),
            DOI: 10.1016/S0140-6736(95)92841-3 Back

 9.    H M Weingartl, et. al., Transmission of Ebola virus from pigs to non-human primates,
            Scientific Reports 2, Article number: 811 doi:10.1038/srep00811 November 15, 2012 Back

10.    L M Brosseau, ScD, and R Jones, PhD, COMMENTARY: "Health workers need optimal respiratory protection for Ebola,
            of the School of Public Health, Division of Environmental and Occupational Health Sciences,
            at the Univ of Illinois at Chicago, Sept 17, 2014, guest commentary published by Univ of Minnesota
            Center for Infectious Disease Research and Policy. Back

11.    Mae Azango, Liberian Doctor Defends 3-5 Days Ebola Treatment With HIV Drug, Sept 29, 2014, AllAfrica.com Back

12.    WHO Ebola Response Team, Ebola Virus Disease in West Africa - The First 9 Months of the Epidemic and Forward Projections,
            N Engl J Med 2014; 371:1481-1495October 16, 2014DOI: 10.1056/NEJMoa1411100 Back

13.    U.S. CDC, Quarantine & Isolation, U.S. CDC, accessed October 2014. Back

14.    J V Chamary, 4000 Deaths And Counting: The Ebola Epidemic In 4 Charts, Oct 13, 2014, Forbes.com Back

15.    U.S. CDC, Prevention, Plague History, Accessed October 2014, U.S. Centers for Disease Control. Back

16.    U.S. CDC, Plague in the United States, Accessed October 2014, U.S. Centers for Disease Control & Prevention. Back

17.    Jim Miklaszewski and Courtney Kube, Obama Authorizes National Guard, Reserves for Ebola Fight, October 16th 2014, NBCNews.com Back

18.    James Simpson, Destroying the border and endangering Americans to achieve a political majority, Aug 8, 2014, The Examiner
          Navideh Forghani, Undocumented Immigrants bringing diseases across border?, Jun 6, 2014, ABC15.com (Arizona) Back

19.    Glenn Beck, Cloward, Piven and the Fundamental Transformation of America, Jan 05, 2010, FoxNews.com Back

20.    Robert Davi, Bill Ayers, Communism, and the Fundamental Transformation of America, Sept 1, 2014, Breitbart.com Back

21.    Greg Richter, Dick Morris Tells Hannity: Obama Pushing for One-Party Rule, Oct 3, 2014, Newsmax.com Back

22.    Bob Just, Democrat Voter Strike: Change Our Party Now, Exclusive: Bob Just wants ballot-box message sent to Alinskyite leadership, October 21, 2014, Worldnetdaily.com Back

23.    Judie Brown, Obama's war on God, Aug 3, 2012, RenewAmerica.com Back

24.    U.S. CDC, Viral Special Pathogens Branch, U.S. CDC, accessed October 2014. Back

25.    National Nurses Union, Ebola-Related Bargaining Demands, October 2014, National Nurses Union Back

26.    U.S. CDC, Guidance on Personal Protective Equipment To Be Used by Healthcare Workers During Management of Patients with Ebola Virus Disease
           in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing)
, U.S. CDC, October 20, 2014 Back

27.    Ron Panzer, Unmasking the Dragon, July 18, 2014, Hospice Patients Alliance Back

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