Monthly Archives: October 2014

Quarantine lifted on Kaci Hickox

A judge today lifted the quarantine on Kaci Hickox. This is great news for those who value freedom and liberty. The government should not be able to restrict a person’s movement based on the fear of the populace. There should be clear evidence that the person poses an immediate threat to others, and in this case, there is zero evidence that Ms Hickox has Ebola.

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Conversations with Patients

“You know, it used to be a lot bigger. People always used to say it was really big. Now it’s so tiny, I can barely find it. I haven’t even used it for six years.”

This would fall under conversations your nurse does NOT want to have while he’s helping you use a urinal.

In other news, drinking a fifth of vodka a day is not good for you.

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IVs

Starting IVs is one of the really fun parts of my job. When I first met my girlfriend, my first thought was “Wow, she’s gorgeous.” Second was, “And she’s got great veins!”

Nothing more satisfying than the little “pop” feeling of the needle going into the vein, and seeing the flash of blood. Ok, I’m being creepy again. But it IS really nice.

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Quarantine

When is it appropriate to institute a quarantine on an individual? This has been on my mind quite a bit for the past few weeks. To my mind, this would fall under the same criteria as any other use of force. With the non-aggression principle, the only valid use of force is defensive force, and you should use the minimum force necessary. Someone with a contagious disease is a threat to others’ health and lives. So others are justified in using force to control that threat, and impose a quarantine.

However, to be just, there has to be a rational threat from the person. Just that they give you a bad feeling is not justification for using force. This is the case with the current quarantines of asymptomatic people who have been near people with Ebola. The evidence is in: Ebola is not casually contagious in asymptomatic individuals. Duncan didn’t spread Ebola to anyone other than nurses working in very close contact with him when he was very sick. None of his casual contacts caught the disease, even his family living in the same apartment never caught Ebola. In the absence of evidence that these people pose an immediate and significant threat to others, imposing a quarantine is unjust.

Also, some seem to have forgotten what the word “voluntary” means. On NPR a few days ago, they said that people would need to “voluntarily quarantine” themselves in their house, or they would be subject to a mandatory quarantine. How does that sentence make any sense?! If you have to lock yourself in, or others will lock you in, that would be a mandatory quarantine already, wouldn’t it?

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Rand Paul: Libertarians should vote Republican

Rand seems to think we’re dumb. I don’t seem to remember a big push from the Republican party for personal liberty in the past several years. Let’s see how the Republicans have done lately:

1) Close the borders – i.e., expand the police state.
2) Opposed the legalization of marijuana, including for medical use
3) Supported federal and state bans on same sex marriages and unions
4) Always fight to expand the military industrial complex and overseas adventurism
5) Supported NSA wiretapping and government spying in all forms
6) Continue to castigate Chelsea Manning, Edward Snowden, and other whistleblowers as traitors
7) Perpetually preach the need for us to be slavishly devoted to the USA and its government
8) Have blocked efforts to close Guantanamo
9) Continue to defend those who committed and authorized torture

Oh, and the last time we had a Republican in charge, he bailed out the banks and auto manufacturers at a massive cost to the rest of the country. They have not reduced taxes, have not reduced spending, have not reduced inflation, and have not reduced government intrusion in our lives. They are just as anti-freedom as the Democrats.

“Fool me once, shame on you. Fool me – can’t get fooled again.”

Personally, I’ll be sitting this election out. The thought of supporting either party makes me want to vomit.

H/T to SayUncle

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Ebola!

I’m very confused by the current efforts to contain Ebola. First, there were cries for a total travel ban from West Africa. Now some areas have implemented a less aggressive measure requiring a quarantine following arrival in the USA if you’ve had exposure to Ebola patients. But the same people who were crying for a travel ban are now opposing the quarantine. Make up your minds, people!

I think the quarantine is silly too. The general population has nothing to worry about as far as Ebola goes. If you see someone sweating profusely and vomiting blood, yeah, stay away from them. No quarantine needed for people who are asymptomatic. It isn’t some deep mystery how Ebola has spread so widely in Africa. Their funeral rituals involve kissing and bathing the deceased, and shortly after death, Ebola is highly contagious. So of course, the disease spread rapidly at first. Since then, it has been limited resources and ignorance that have prevented control of the disease. The countries with large outbreaks have been too strapped for resources to effectively quarantine all their symptomatic Ebola patients.

In the USA, even with the usual bumbling of the government and corporations, a grand total of two people have caught Ebola in the USA. This was due to the ridiculously insufficient PPE (Personal Protective Equipment) provided to those carrying for Duncan in the early days of his care. Our yellow gowns and single layer of gloves are a joke in the face of essentially anything contagious. They haven’t been effective in preventing the spread of MRSA and C Diff, so obviously won’t be effective in preventing the spread of Ebola. Once proper PPE was implemented, transmission was stopped completely.

So we need to have two effective steps in stopping Ebola:
1) Identify those who may have Ebola. Have you or any close contacts traveled to West Africa in the past three weeks? Have you had any contact with the three people who are currently symptomatic with Ebola in the USA? No to both? Not Ebola.

2) Isolation. Place the handful of possible Ebola cases in real isolation. No one in or out except essential medical personnel. Train a team at each hospital to provide care for Ebola patients. Provide real training and practice in full coverage PPE. Training for everyone else should be to stick any possible Ebola patient in the nearest room and stay the hell away from them. Offer double pay for the Ebola Response Team if an Ebola patient does show up, and you’ll have people volunteering for it.

Our government sucks at implementing anything like this, so hopefully hospitals will reach this conclusion on their own. My hospital hasn’t, last email I saw still had us going in with yellow gowns, booties, gloves, and a mask. Our ‘training’ consisted of an online training module. No Ebola Response Team in place. Supposedly we’re supposed to consider upgrading to full body coverage PPE if the patient has copious amounts of bodily fluids, but none of us have seen this PPE, much less practiced donning and doffing. So while the general populace doesn’t have much to worry about, those of us who provide medical care to patients should be pushing hard to get a better response plan at our hospitals! I’ve let my director know my concerns, and supposedly they’re working on a better plan.

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