Is a 21-Day Ebola Quarantine Really Adequate?

Ebola Virus Natural News nutjob Mike Adams (a.k.a.
the self-styled Health Ranger) is certainly trying to fearmonger
the idea that 21-days is not enough. First, remember that this is
the guy who the FBI is investigating for surreptitiously setting up
a website earlier this year where he
likened crop biotech researchers to Nazis
and then
argued…

…it is the moral right — and even the obligation — of human
beings everywhere to actively plan and carry out the killing of
those engaged in heinous crimes against humanity.

So consider the source when Adams writes:

A jaw-dropping report released by the World Health Organization
on October 14, 2014 reveals that 1 in 20 Ebola infections has an
incubation period longer than the 21 days which has been repeatedly
claimed by the U.S. Centers for Disease Control. …

This means that Ebola-infected U.S. citizens who are
“cleared” of Ebola may still erupt with the deadly virus for a
period of three more weeks.
(emphasis his)

Why hasn’t anyone reported this until now? How is this not one
of the single most important pieces of information in the world at
this moment when all human life on our planet is now legitimately
threatened by an uncontrolled viral outbreak with a 70 percent
fatality rate and no recognized treatments or cures?

Adams is essentially putting his panicky spin on the World
Health Organization’s situation
assessment
for Ebola in Nigeria and Senegal that states:

The period of 42 days, with active case-finding in place, is
twice the maximum incubation period for Ebola virus disease and is
considered by WHO as sufficient to generate confidence in a
declaration that an Ebola outbreak has ended.

Recent studies conducted in West Africa have demonstrated that
95% of confirmed cases have an incubation period in the range of 1
to 21 days; 98% have an incubation period that falls within the 1
to 42 day interval. WHO is therefore confident that detection of no
new cases, with active surveillance in place, throughout this
42-day period means that an Ebola outbreak is indeed over.

Presumably the WHO is also setting a 42-day time limit in order
to make sure that unaccounted for cases do not emerge before for
declaring an epidemic at an end.

Adams apparently thinks that people infected with Ebola who
remain asymptomatic for more than 21-days are somehow like modern

Typhoid Marys
. This is wrong. Typhoid Mary was an asymptomatic
carrier of that bacterial disease, whereas people infected with
Ebola pass along the illness only after they become
symptomatic.

Those interested in less senational and more accurate coverage,
can go over to The National Journal, to read Brian
Resnick’s terrific article that asks, “Is
21 Days Enough for Ebola Quarantine?
” Resnick is focusing on
calculations published in
PLoS Current Outbreaks
by Drexel University researcher
Charles Haas who finds:

While the 21 day quarantine value currently used may have arose
(sic) from reasonable interpretation of early outbreak data, this
work suggests a reconsideration is in order and that 21 days may
not be sufficiently protective to public health.

Haas does importantly add:

The estimate of appropriate incubation time would need to
explicitly consider the costs and benefits involved in various
alternatives, which would incorporate explicit computations from
transmission modeling.

Let’s take a stab at roughly toting up the costs and benefits.
In a first scenario assume notionally that 20 people are infected
with Ebola and 19 become symptomatic before 21 days.
If they are placed in effective quarantine, the 19
will either die or get well in which case they are no longer a
threat to public health. What about the one who becomes symptomatic
after 21 days? There is no magic to the 21-day incubation period,
since an infected person who is symptom-free until 30 days or 42
days will anyway not be passing the disease on to anyone.
(Remember: No Ebola Marys.) Once the person whose incubation period
stretches beyond 21 days becomes symptomatic, he will presumably be
quarantined as well and like the others die or get well.

In the current epidemic in West Africa, the number of people to
whom each infected person passes the contagion on to is estimated
to be
around 2
. In other words, each person ill with Ebola is now
infecting 2 people. To control an epidemic, the reproduction number
must fall below 1, at which point ever fewer people become
infected. In order to drive the reproduction number below 1 in West
Africa, it is estimated that 70 percent of infected people must be
quarantined.

Bear in mind that in unvaccinated and uninfected populations,
the effective reproduction
number
for measles, whooping cough, smallpox, and polio is
estimated to be between 12-18, 12-17, 5-7, and 5-7 people
respectively.

So the 1 person out of 20 who becomes symptomatic after 21 days
will likely infect 2 people. The chance that these 2 newly infected
people will remain symptom-free for more than 21 days is also 5
percent. As you can readily see, the number of infected people who
remain symptom-free for more than 21 days declines steeply with
effective quarantine.

But let’s say that public health officials impose an even more
stringent quarantine. In this case, if 100 people merely suspected
of being exposed through casual contact (not body fluids) to Ebola
are quarantined for 21 days, presumably 95 of them would either
come down with the illness or show no symptoms. If quarantine
works, then those who come down with the disease would either
survive or die and the symptom-free will be released. In either
case, 95 of those who had been in quarantine would no longer be a
danger to the public.

What about the postulated 5 who become symptomatic after a
21-day quarantine? Aren’t they a menace to the public’s health?
Let’s begin by assuming that the 5 people who become symptomatic
(and thus contagious) after leaving quarantine come into contact
with 10 people each after their symptoms begin. I am postulating
this as a reasonable number of contacts after symptoms occur
because if the people who had been previously quarantined for 21
days due to possible exposure to Ebola are like me, they would be
obsessively monitoring themselves and run to a hospital quickly if
they feel ill. Although they were not in quarantine
(self-monitoring instead) both of the Dallas nurses who are now
infected with the virus basically did do this. Unfortunately, one
nurse who reported an elevated temperature was told not to worry
about it and flew off to Cleveland.  

In any case, my stringent scenario implies that 50 people
exposed to the folks who become symptomatic after 21 days would
subsequently be quarantined. Of the 50 people now in quarantine
perhaps 10 would be infected (reproduction rate of 2). The chance
that just one of the infected people now in quarantine would remain
asymptomatic until after 21 days is low (5% X 10 people = ½
person). But let’s assume the bad luck that one does become
symptomatic after quarantine and they too come into contact with 10
people. Of those 10 who are now in quarantine, assume that two are
infected. It becomes increasingly unlikely (5% x 2 people =
1/10th person) that the infected would become
symptomatic after 21 days. And so on through subsequent stages of
quarantine.

Anecdotally, three missionaries with SIM USA were
quarantined for 21 days
after being in contact with Ebola
patient Nancy Writebol who was flown from Liberia and successfully
treated at Emory University Hospital in August. None of them,
including her husband, came down with the disease. It is also the
case that the four quarantined
people
who lived in the Dallas apartment with Liberian Ebola
patient Thomas Eric Duncan have so far not fallen ill. Their 21-day
isolation period ends this Sunday.

Finally, as Haas notes, deciding what limits to place on
quarantine come down to a benefit/cost judgment. At this point, the
21-day period for quarantine seems adequate for effectively
protecting public health.

For more background, see my article, “How
Cutting-Edge Medicine Might Have Spared Us the Ebola
Epidemic
.”

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[VIDEO] WV Officers Proudly Spend Year Busting Ginseng Diggers (Don’t Cops Have Better Things to Do?!)

“WV Officers Proudly
Spend Year Busting Ginseng Diggers (Don’t Cops Have Better Things
to Do?!)” is the latest video from ReasonTV. Watch above or click
on the link below for video, full text, supporting links,
downloadable versions, and more ReasonTV clips.

View this article.

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New: Obamacare’s Unknowable Price Tag

The federal deficit is down this year and President Obama says
it’s most because of health-care reform. But how much will
Obamacare end up costing over the long run, ask Nick Gillespie and
Jason Keisling.

If past is prologue, bet on “much more than expected.”

View this article.

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Good DC Residents May Again (Legally) Carry Guns to Defend Themselves Against Criminals Who Always Did

Concealed CarryAfter a long hiatus in respect
for individual self-defense rights, Washington, D.C. will, once
again,
accept applications
for permits to carry concealed pistols.
This should put the honest residents of that unpleasant burg—at
least, the ones who feared the old law enough to abide by it
despite the capital city’s impressive crime rate—on a
more even footing with the two-legged predators who never gave a
shit about the ban on concealed carry.

The
statement from Police Chief Cathy L. Lanier
is suitably
grudging, coming as it does from from the chief enforcer in the
federal government’s nest:

Mayor Vincent C. Gray has signed emergency legislation, the
“License to Carry a Pistol Emergency Amendment Act of 2014,” passed
by the Council of the District of Columbia in response to the
ruling by the U.S. District Court in the case of Palmer v. District
of Columbia.  This law maintains our commitment to keeping
guns out of the wrong hands and ensures the safety of all within
the District of Columbia, while fully respecting the Second
Amendment of the U.S. Constitution. 

The law cures the alleged constitutional flaws in the District’s
licensing laws found by a U.S. District Court in the Palmer
case.  The summary judgment ruling in that case was stayed
until October 22, 2014, giving District officials time to issue
regulations authorized by this legislation. Once these are issued,
members of the public who meet the statute’s criteria will be able
to apply for a license to carry a pistol in the District. 

In the meantime, except as authorized for law enforcement,
carrying a gun in public remains a criminal offense, and anyone
found doing so will be subject to arrest.

The new regulations can be expected to be restrictive,
burdensome, and applied with the sort of non-enthusiasm bureaucrats
always bring to the job when forced to loosen, however slightly,
the yoke on little people. They’ll be a far cry from the generally
red tape-free “Vermont
Carry
” that prevails in several states that don’t require
permits to put the means of self-defense in your pocket.

If the regulations are prohibitively burdensome, D.C. residents
who consider the risk of going unarmed unacceptable will no doubt
continue to practice what I like to call “East Village Carry”
(after a neighborhood I prowled for several years). They’ll put
guns in their pockets anyway, gambling that the benefit outweighs
the risk of being caught in violation of the city’s laws.

Because that’s what the predators have always done, no matter
what the law says.

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Occupational Licensing of Strippers Isn’t Just Unnecessary, It’s Dangerous

We write a lot at Reason about the
perils
of occupational liscensing
—how it serves as a barrier to entry
for many otherwise qualified hair
braiders
or horse
masseuses
 or
costumed superheroes
; how it’s often based on
little more than protectionism
for those already in an
industry; how it further bloats the regulatory state. Add another
negative to the list: It can make people’s private information a
matter of official record, and thus fair game for public records
requests. In some industries, such as those involving adult
entertainment, you can see how this may get a little
touchy. 

Dancers and managers at a Washington state strip club are now
suing to stop their county from releasing their names, photos, and
other identifying information to a man who has filed a public
records request for it. The complaint, filed in U.S. District Court
in Tacoma Tuesday, says the Pierce County Auditor’s Office received
a request from David A. Van Vleet for copies of all adult
entertainment licenses on file for Dreamgirls at
Fox’s. Why does this man want identifying info on
current and former dancers at the Tacoma-based strip club? Nobody
knows. (I reached out to Van Vleet yesterday but haven’t heard
back.) But because strippers in most areas of Washington must
obtain an “entertainer’s license”, their identities are a matter of
public record.

Attorney Gilbert H. Levy acknowledged that the information was
technically fair game under the state Public Records Act, but said
the privacy and safety interests of strip club workers necessitates
keeping their real names and identities confidential. “It’s a
unique occupation and it’s a controversial occupation,”
Levy told CBS Seattle
. “Some people like nude dancers, and
other people for religious or for other philosophical reasons
don’t. There’s some stigma attached to the occupation, and most
dancers for personal privacy reasons and safety reasons, don’t want
the customers to know who they are outside of the club.” 

In other words, it’s entirely likely the person who wants this
information is a crazy stalker or an anti-sex nutjob. Maybe both.
Maybe merely a blackmailer or a 4chan-er. At any rate, it’s hard to
imagine many non-nefarious reasons for requesting personal
information on a wide swath of individuals in a sensitive
job. 

Pierce County Auditor Julie Anderson told CBS it wasn’t her
office’s job “to interpret what the requester’s intentions might
be.” And that’s legit. That’s a key part of government
transparency, in fact, that random administrators can’t
subjectively block public records requests. There’s just no reason
these women’s identities should be a matter of public record in the
first place. There’s no reason city or county or state governments
need a stripper database. 

This isn’t the first time Pierce County, Washington, has faced a
conundrum concerning stripper record requests. In 2013 a man who
had been arrested for stalking and was serving time in jail for
assault sought information on area strippers—hoping, he says, to
proposition them about using his marketing expertise to become
social media stars. According to Seattle-based Komo 4 News, the
man, Robert
Hill, received around 100 dancer files
—including their names,
addresses, and phone numbers—from the county before strip club
workers sued to block him from receiving any more
records. 

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A.M. Links: Obama Open to Ebola Czar But Not Travel Ban, FBI Director Wants to Ban Cellphone Encryption, Royals-Giants World Series

  • Royals winPresident Obama says he’s open to an
    Ebola
    czar but not a travel ban. The Dallas nurse who
    contracted Ebola from a patient she was treating arrived in

    Maryland
    for treatment, while a Dallas lab worker on a cruise
    ship off the coast of
    Belize
    has been quarantined because he handled the Ebola
    patient’s specimen.
  • FBI Director
    James Comey
    is worried that Apple and Google allow users to
    encrypt their phone and called on Congress to pass a law to stop
    them from doing that.
  • The U.S. and
    Iran
    remain cautiously optimistic about ongoing nuclear
    talks.
  • A poor economy and a plunging ruble don’t seem to be having
    much of an effect on the popularity
    Vladimir Putin
    enjoys in Russia.
  • Venezuela, Spain, New Zealand, Malaysia, and Angola were
    elected to the
    United Nations Security Council
    as non-permanent members.
  • The
    Kansas City Royals
    completed their sweep of the Baltimore
    Orioles and will advance to the World Series to face the
    San Francisco Giants
    , who are making their third appearance in
    the last five years.

Follow Reason and Reason 24/7 on
Twitter, and like us on Facebook. You
can also get the top stories mailed to you—sign up
here
.

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Kurt Loder Reviews Birdman and Fury

Comebacks are hard. Twenty years ago, Riggan
Thomson (Michael Keaton) was an international movie icon—the masked
and feathered crime-fighting superhero Birdman. He bailed out of
the franchise after three pictures, but the typecasting damage to
his career was done. Now, low on dough and desperate for
redemption, he’s determined to stake a claim as a serious actor. He
has adapted a very serious Raymond Carver story and is bringing it
to Broadway, with himself as both director and star. It’s not going
well. New York theatre snoots dismiss him as a Hollywood has-been,
and tabloid jackals pepper him with off-topic questions like, “Is
it true you’ve been injecting yourself with semen from baby pigs?”
Worse yet, the Birdman—feathers and all—is making a comeback, too.
What a nightmare. Kurt Loder applauds
Birdman, writing that few movies attempt to do
anything this fresh.

View this article.

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Americans Favor Airstrikes to Combat ISIS But Are Unsure How to Pay for It, As Usual

The latest
Reason-Rupe poll finds
 that a solid majority—66 percent—of
Americans favors
conducting air strikes against ISIS in Iraq and Syria
.
While 52
percent oppose sending ground troops to Iraq
, 58 percent
believe sending at least a small number of troops (24%) or even a
large number (34%) will be necessary to successfully combat
ISIS.

While Politicians often wish to avoid discussing trade-offs, the
Reason-Rupe poll asked Americans how they would like to pay for
military against ISIS in Iraq and Syria. Somewhat predictably, two
groups emerge: 35 percent say cut non-entitlement federal spending,
another 34 percent say raise taxes on wealthy people. Another 8
percent say we should raise taxes on all income groups, 6 percent
want to borrow the money, and 4 percent want to cut entitlement
programs to pay for military action.

If federal spending had to be cut to pay for military action,
Americans say they would first cut social safety net programs (19%)
like food stamps, unemployment benefits, and Medicaid, another 17
percent say they would cut infrastructure and transportation
spending. Nine percent would cut government-funded science and
medical research, 7 percent would cut entitlement programs, 3
percent would cut education, 2 percent would cut veterans programs.
In fact, a total of 8 percent actually volunteered another answer
that was not offered on the survey: cutting Congressional salaries.
Another three percent said there were literally no programs that
could be cut. One middle-aged man from Philadelphia said “none of
the programs” could be cut because “they are all vital to our
survival.” Twelve percent offered a variety of other smaller
programs to cut, and another 19 percent didn’t know what to
cut.

Overall, these data reflect a predictable pattern—Americans want
other people to bear the costs of various government activity,
either in form of taxing rich people or cutting social services for
low-income individuals.

The Reason-Rupe national telephone poll, executed
by Princeton Survey Research Associates International,
conducted live interviews with 1004 adults on cell phones (503) and
landlines (501) October 1-6, 2014. The poll’s margin of error
is +/-3.8%. Full poll results can be found here including
poll toplines (pdf) 
and crosstabs (xls). 

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Friday A/V Club: Rock ‘n’ Roll Commie Werewolves

This 1982 SCTV sketch mashes up a monster movie with
the Red Scare and a bunch of ’50s moral panics, from the
rising tide of juvenile delinquency to the alleged evils of rock
‘n’ roll. The story also incorporates a musical number by former
Rockpile guitarist Dave Edmunds, and it’s interrupted midway
through so a tattoo-faced John Candy can advertise a sex shop. Oh,
and Eugene Levy is basically playing Lenin. In short, it just might
be the best 12 minutes of ’80s television ever aired:

(For past editions of the Friday A/V Club, go here.)

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New York Spent a Record $1.1 Billion on Jail Last Year, and Got Even More Violence

New York City’s criminal justice system
continues to have severe problems. Rikers Island prison, New York
City’s primary jail facility, has more staff and fewer inmates than
in previous years—and yet it also has sky-high costs and increasing
levels of violence, according to a forthcoming comptroller’s report

reviewed in an article in The New York Times
.

The cost is higher than ever, and way out of proportion with
comparable urban areas. The City of New York spent $1.1 billion to
run its jails last year, a record sum, according to the report.

Housing a prisoner for a year in New York cost the city’s
Corrections Department $100,000 last fiscal year. That’s a huge
increase from a few years ago, and much higher than in other major
metro jail systems. As the Times notes, the cost “is 42
percent higher than seven years ago and more than twice the amount
spent per inmate by correction departments in other large cities
like Chicago and Los Angeles.”

Those cities have larger jail populations but significantly
lower costs per person housed:

New York spends far more on its jails than other large American
cities, even those with much larger inmate populations. Los
Angeles, for instance, has an inmate population of nearly 19,000,
about 7,000 more than New York. But taxpayers there spend only
$44,965 a year per inmate, nearly half what New Yorkers spend,
according to the report. 

But the skyrocketing costs haven’t resulted in a more peaceful
prison system. In fact, the city’s jails have become even uglier
even as spending has ramped up. During the fiscal year that ended
in June, the Times says, “there was a 124 percent increase
in assaults on the staff by inmates at city jails, and triple the
number of allegations of use of physical force by guards.”

The violence at Rikers is horrific, and the city has tried to
hide it from public view. A July
report
from The New York Times is chilling:

[The Times] found that over an 11-month period last
year, 129 inmates suffered “serious injuries” — ones beyond the
capacity of doctors at the jail’s clinics to treat — in
altercations with correction department staff members. The report
cataloged in exacting detail the severity of injuries suffered by
inmates: fractures, wounds requiring stitches, head injuries and
the like.

The report was based on information that the city health
department refused to make public. 

Union representatives for prison guards have long argued that
the solution is more guards. And it’s true that the number of
guards in the city’s jail system has declined somewhat, from about
9,200 in 2007 to 8,922 this year.

But those guards are also tasked with guarding a declining
prison population, and so the ratio of guards to prisoners
has actually increased by 19 percent, according to the report. In
other words, each guard now has fewer prisoners than ever to look
after.

That hasn’t helped. According to the Times, “a vast
majority of the cost in New York, about 85 percent, goes to pay for
personnel.” Much of the excess spending can be
attributed to overtime, which is apparently not being limited the
way it’s supposed to.

The improved staffing and lower inmate population have somehow
produced a counterintuitive result, translating into a rise in
overtime costs to $139 million in 2014 from $101 million in 2007,
the report said.

Correction Department regulations are supposed to limit the
amount of overtime a guard can work to 57 hours a month. But
Elizabeth Crowley, a City Council member who oversees corrections,
said that some officers worked as much as 80 hours a
month. 

Scott Stringer, the comptroller who put together the
report, was blunt when he spoke to the
Times
about the situation in the city’s jails,
saying: 
We’re spending more money on inmates and
we’re getting worse results.

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