Just a Couple More Thoughts by Pat Conrad MD

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Follow up on Dr. Spencer…

From Medscape: “With African-derived Ebolavirus infection, there is an incubation period (typically 3-8 days in primary cases and slightly longer in secondary cases).” Various reports give the virus a latency of 3 – 21 days. Dr. Spencer’s exposure was the primary type.

He left Guinea on 10/14, and developed fever, followed by presentation to Bellevue ER in HAZMAT garb on 10/23, a period of 9 days. This was consistent with primary infection. Now Dr. Spencer has recovered and has been released from the hospital and quarantine, declaring, “Today I am healthy and no longer infectious.” That’s good news. But while we’re tossing the laurels…

Assuming that Spencer reported his fever as soon as it occurred, he did follow established protocols. “He said the established protocols for healthcare workers (twice daily monitoring of body temperature and self-quarantine if symptoms arise) returning from West Africa are what saved his life. “I am a living example of how those protocols work,” Spencer said.” NY Mayor Bill de Blasio said “Doctor Spencer did everything right”, referring to the heat the borderless doc had taken for rambling around the city after returning. Which begs the question Mr. Mayor, why did he lie to police about his movements in the days preceding active symptoms?

Why do Doctors Without Borders and the CDC believe that casual contact is a high enough risk to necessitate full protective gear in country, but not after an individual has returned home the next day? With varying latency/incubation times, why is a more stringent quarantine protocol not in place for those returning to the general public? Why would not Spencer – the owner of a master’s degree in public health – push for tougher quarantine protocols consistent with the incubation period to better reassure the public that an African virus would make no further appearance here?

It is expected that a red-ribbon leftist like New York Mayor de Blasio would not only try to make political hay, but use this case for gratuitous photo-op moralizing: “Doctor Spencer is Ebola-free, and New York City is Ebola-free… “It’s a good feeling to hug a hero.” And then de Blasio just had to add, “”You never discriminate against someone that’s helping others,” said the mayor, adding that “no one should be stigmatized based on where they come from. That is an un-American act.”

Morgan Dixon, Spencer’s fiancée tested positive for Ebola shortly thereafter, and was released from the hospital for a home quarantine until 11/14. Since Dr. Spencer’s actions declared that Ebola is not spread by casual contact in the western hemisphere, why should poor Ms. Dixon have to suffer the indignity of virtual house arrest in the absence of fever? No doubt she had supported Dr. Spencer the Hero, so isn’t it un-American to discriminate against her?

While I don’t think we should give in to hysteria and overreact to this virus (never did), neither should we be stupid regarding a serious contagion while misdiagnosing a “hero.”

 

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “Just a Couple More Thoughts by Pat Conrad MD

  1. politovski
    November 15, 2014 at 12:24 am

    wow. we are unbelievably cavalier with an infection with such a high mortality rate. i cannot believe what i read sometimes. why are these people not under strict quarantine for 21 days? ludicrous. thankfully the virus does not seem to be quite so bad here in the states, but that was more luck than any success or intelligence on our part. we very well could have had something that could have infected everyone in contact. then all of these goofballs would have been responsible for a multitude of deaths. unconscionable from doctors and nurses who should know better. some example we are. very disheartening. but, i suppose (considering the quality of our public servants and business leaders) that that really is the best we have to offer. as they say, garbage in, garbage out….

  2. Bill Ameen
    November 14, 2014 at 10:07 am

    Dr. Spencer exhibits the hubris of a lot of ER doctors I’ve known. Now that he’s cured and supposedly immune, he really should go back and treat Ebola patients in Africa. But, oh, I forgot, they don’t have bowling alleys over there…

  3. RSWatkins
    November 14, 2014 at 7:52 am

    “It is expected that a red-ribbon leftist like New York Mayor de Blasio would not only try to make political hay”

    But phrases like “red-ribbon leftist” certainly elevate the tone of the discussion.

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