Tag: strategy

Ebola Outbreak Kills an American, Highlights Need for Improved Travel Screening

On By The Social CriticIn Health & EnvironmentLeave a comment

A 25-year-old man who in March was diagnosed with tuberculosis was arrested some 15 miles outside of Bakersfield, California, after vacating a motel room in which he was ordered to remain while receiving treatment.

Half a world away, The World Health Organization has confirmed more than 800 Ebola cases in three West African nations. Thus far, one American has died and two more are gravely ill.

Appearing Tuesday, July 29 on CNN to address the concern that Ebola’s emergence outside of West Africa may be but one airline flight away, Dr. Marty Cetron, director of the CDC’s Global Migration and Quarantine Division, indicated that preparation, recognition and containment is “more important than speculating on propababilites of disease moving around by plane”.

The CDC describes the risk of Ebola showing up in the United States as “remote”. The American widow of a top official in the Liberian Ministry of Finance, whose spouse collapsed and later died, sees it differently. Decontee Sawyer told a Minnesota news station that the outbreak “is as close as the front door”.

The contrasts are stark: On the one hand, long-accepted efforts to contain the spread of TB have allowed for the arrest and forcible quarantine of an uncooperative patient in California. On the other hand, the CDC has done little more than issue an advisory to U.S. doctors regarding the West African outbreak. Notably missing from the CDC’s response is the means by which the agency is working to prevent Ebola’s emergence here on the home front.

Perhaps fear of public panic has shuttered what are, in fact, more proactive containment efforts behind the CDC’s closed doors. Whatever the case may be, the public face of the CDC on the heels of several domestic near-misses would appear to be oddly passive. Impacted nations in West Africa have begun to shut down borders and to screen prospective airline passengers, yet prevention efforts within the U.S. are at best low key. The CDC’s efforts to assure reporters that North Americans have little to fear may signal reassurance to some, but may also play like a case of institutional hubris: “It won’t happen here.” and “Our medical system is too sophisticated to have it go far if it does.”.

Anyone who has sought timely treatment from the Veteran’s Administration or shown up at a suburban emergency room, as I did earlier this year, without so much as an available wheelchair or gurney might beg to differ with the notion that the U.S. health care system is in any way, shape or form prepared for a natural disaster on the order of Hurricane Katrina, let alone global pandemic. But we live in a society in which saying that we’re safe often passes for the real thing, thanks to a coping mechanism known as the “normalcy bias“.

Call it denial or call it overconfidence, our vulnerabilities tend to remain unchallenged until the unthinkable occurs. Ebola notwithstanding, we remain at risk of “medical terrorism” — that is, terrorists’ use of infectious people as biological weapons. As efforts to board airliners with conventional explosives fail, it is not beyond the scope of possibility that terrorists will board seriously ill passengers on international fights as an alternative.

Isn’t it time we walked the walk of public safety, not merely talk the talk?

In view of the gaping security hole we have tolerated all these years as we focus on shoe and even cell phone bombers — and now with the impetus of the Ebola outbreak at our backs — might it be appropriate to implement a brief health screening, executed in tandem with the screening procedures international travelers are already accustomed to?

Step 1: Check for fever. There are non-invasive means of doing so, and as a timesaver this could be done while passing baggage through scanners.

Step 2: Using multilingual pamphlets as an aid, ask prospective international travelers six questions:

1) Have you or someone you are traveling with recently come into contact with an individual hospitalized for a communicable illness?

2) Have you or someone you have recently come into contact with experienced nausea or diarrhea, not related to a previously diagnosed medical condition?

3) Are you presently experiencing body aches not related to physical exertion or a previously diagnosed medical condition?

4) In the past 72 hours have you experienced unusually severe or persistent headaches, not related to a known condition such as a migraine?

5) In the past 72 hours have you developed a sudden, persistent or severe cough, not related to a previously-diagnosed condition?

6) Have you experienced rapid or severe irritation of the throat or skin within the past 72 hours, not related to a previously-diagnosed medical condition?

Thanks to technology, public health officials could be made available over Skype to address any questions that may arise out of such screening. Alternately, nurse practitioners could be employed by the Transportation and Security Administration (TSA) to evaluate travelers who are flagged for fever and/or for answering “Yes” to two or more questions indicated above. To be clear, these efforts would not reveal the cause or seriousness of such symptoms. Even so, with cancer patients, the very young, the very old and the immuno-compromised vulnerable even to ordinary communicable illnesses, a greater emphasis on infectious disease prevention can only help, not harm, society. In the broader view, moreover, efforts to normalize screening measures could perform a valuable public service. It could help drive home a universally-relevant message — that it is best to stay home while ill — and thus prime the public to take proper precautions and/or heed public health warnings in the event of a genuine pandemic threat.

Ebola in West Africa may indeed come and go, leaving the developed world largely untouched. But tragedies like this are opportunities, too. The Ebola outbreak highlights the need for authorities to make international travel by airline and cruise ship safer. Far from triggering panic, routine screening efforts are likely to become accepted in due time. In this way, should an even greater pandemic threat emerge, there will already be people and procedures in place to identify and curtail the spread of infectious diseases at international travel hubs — all without raising undo alarm. If public health officials are at all concerned that new or intrusive efforts to step up prevention will only provoke needless panic, a desensitizing strategy in which such screenings become the norm, not the exception, would go a long way toward putting to rest much of the debate: Do we act now or do we wait?

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Straight Talk to Conservatives: What it Will Take in 2012

On By The Social CriticIn Politics & Public PolicyLeave a comment

The 2008 presidential election offered an opportunity to nominate a candidate who offered a proven mix of conservative and libertarian principles. This individual had 30-some years of experience and unprecedented grassroots support. Although he was the only candidate to counterbalance Barack Obama’s cult-like following with generous numbers of his own homegrown supporters, he never had a shot at the Republican party nomination. He was just too radical for our postmodern times in which questioning the economic sustainability of policing the world and the necessity of Big Government agencies has become taboo.

It is more than ironic how the most “liberal Democrat” in the Senate and an alleged socialist was nominated for the Democratic party and ultimately elected to the presidency, while the candidate who most sharply counterbalanced Obama’s liberalism wasn’t deemed fit for the Republican ticket. This election year, Republicans were seemingly fearful of foregoing a supposedly moderate candidate (Sen. McCain) in favor of nominating an extreme candidate (Rep. Ron Paul). Yet that very act on the flip side of the ticket — pandering to extremes — didn’t seem to hurt the Democrats.

Sen. McCain’s attempt to distance himself from the religious conservative “base” in effect hung those supporters out to dry, a less-than-conciliatory decision that only ceded territory to President-elect Obama. Having said that, however, it would be remiss not to lay some of the responsibility at the feet of religious conservatives: They had their pick of not one but two experienced candidates with a staunchly pro-life position, among other issues, yet aided and abetted by FOX News & Friends sent Rep. Ron Paul and Gov. Mike Huckabee packing.

For all this seemingly partisan commentary, the lion’s share of blame for the loss of the 2008 presidential election belongs at the feet of those who, without compunction, perpetuate the notion that only Republicans care if the nation is attacked by terrorists (or any other ill for that matter). Crackpots like these were present at McCain’s rallies, publicized in the media and ultimately responsible for infusing the McCain campaign not only with a negative tone but a paranoid one. This is the type of PR that no campaign strategist needs or wants, yet Sarah Palin, in particular, attracted the fear and hate-mongers like flies. Toward the end, McCain campaign staffers privately assailed Palin as a “diva”, a loose cannon. In all likelihood, however, Palin made an easy scapegoat for McCain staffers frustrated by the off balance elements who consistently reared their hostile heads at rallies.

Republicans cannot save face until they admit that the Bush Administration has given conservatism a bad rap. President Bush, given not one but two terms and the hindsight of the horrors of 911, failed just as miserably to take out Osama bin Laden as President Clinton. The Bush Administration’s support of surveillance state technologies has violated the Fourth Amendment vis-à-vis former Attorney General John Ashcroft and his even more irreverent replacement, Alberto Gonzales. The Bush Administration yanked our chains after 911, compelling a great deal of the American public to perceive a link between Iraq and 911 that didn’t exist, bungled intelligence that by the 2004 election had already come to light. Yet playing upon our post-911 fear to revive his father’s war — removing Saddam Hussein from power, an otherwise admirable aim but for its poor timing and convenient sales pitch — failed to cost President Bush a second term in office. In no small part that is because many of his hear-no-evil, see-no-evil, speak-no-evil supporters refused to call a spade a spade.

Loyalty to a wartime president is one thing, deeming the Bush Administration infallible, another entirely. That President Bush’s tenor in the White House lived to see another term during which the economy has collapsed and his reputation has further suffered can be attributed to those who refused to read the writing on the wall. The Bush Administration could have been given a graceful exit in 2004, which may have made the “fall guy” for the ensuing four years a single-term Democrat (Sen. John Kerry). Instead, the reelection of President Bush paved the way for Obama, who like President Clinton, may occupy the Oval Office for a long, long time.

Make no mistake, however: The sins of the GOP are by no means relegated to the Bush Administration. For over 25 years Republican leadership has practiced Big Government even as they win elections claiming to represent the opposite. In view of these many contradictions, the irony that so many conservatives harp on fears of a liberal takeover is nothing less than dumbfounding. The nation witnessed the Clinton Administration reform welfare so that it can no longer serve as a permanent crutch, and the Clinton Administration exited office with the first budget surplus in decades. How can anyone in their right mind make a Democrats-are-capable-of-no-good argument with a straight face? Are we still living in 1993? No one will argue that the Clinton years were idyllic. But one thing President Clinton didn’t do is commit presumed liberal sins: tax us into oblivion and run the nation into record deficits. We have President Reagan, H. W. Bush and G. W. Bush to thank for those.

For Republicans to come out ahead in the next presidential election, a period of deep introspection is in order. The actions of Republican leaders have been a part of the problem. Liberals have been perennial favorites in the conservative media shooting gallery for so long that conservatives risk appearing off balance for never so much as aiming a token shot at the bad actors within their own party. Confessing the sins within the Republican ranks would go a long way toward restoring conservative moral and intellectual credibility. It might even win back the respect — and the votes — of those who became disenfranchised enough to “go Blue”.

Only time will tell if GOP leaders and their supporters have the courage to clean house. If conservatives don’t want President-elect Obama or like Democrat to trump the GOP again in 2012, they need to cut out the arrogance and don some humility. The same goes for the poor sports making doom-and-gloom predictions on talk radio and television, forwarding baseless political email rumors to the discredit of their own intelligence, and posting off-kilter comments on news items and blogs. It is all well and good for Republicans to express disappointment over the election outcome, concern even. In fact, given all the problems the President-elect faces, it would be irrational not to feel some degree of trepidation about the future. Voicing over-the-top paranoia, on the other hand, is just plain self destructive.

Bottom line? Republicans need to step out of their own way. If conservatives aren’t too proud to do so, they just might find cause for celebration in 2012.

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