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October 15, 2014

Doctor Frieden: You Can't Catch Ebola From Some Guy Sitting on the Bus With You. But If You Have Ebola, Stay Off the Bus. Somebody Could Catch It From You.

Okay, so.

Dr. Tom Frieden, director for the Center for Disease Control and Prevention (CDC), said during a telephone press briefing Wednesday that you cannot get Ebola by sitting next to someone on a bus, but that infected or exposed persons should not ride public transportation because they could transmit the disease to someone else.


"I think there are two different parts of that equation," he continued. "The first is, if you’re a member of the traveling public and are healthy, should you be worried that you might have gotten it by sitting next to someone? And the answer is no."

"Second, if you are sick and you may have Ebola, should you get on a bus? And the answer to that is also no. You might become ill, you might have a problem that exposes someone around you," he said.

Frieden's answer is silly and nonsensical. There is a way to make this answer work, mostly. I should point out first of all that he (deliberately I think) talks about apples and oranges here, in not one but two places.

The first question does not assume that anyone on the bus does have ebola. Ergo, you start with a one in one hundred million chance that the guy next to you on the bus has ebola. Multiply that by the odds of transmission (let's say one in one thousand, if he sneezes or touches you with a sweaty palm), and, while there is some risk, no one would hold it against Frieden too much for rounding "one in ten billion" down to "zero."

But like I said, he's comparing apples and oranges to get the one figure down to near zero while allowing the other figure -- the chances you will transmit ebola -- high enough to warn against.

He includes the situation that you "become ill" -- you vomit, maybe you sneeze on to someone -- in the second hypothetical. Obviously that presents a much higher risk than someone just sitting there and doing nothing to share liquids except sweat.

The problem isn't so much that he's lying -- I mean, he's rounding down, really -- it's that he's kind of bullshitting people in a way that is perfectly easy to see through, and hence the opposite of reassuring.

I understand the need for him to push down on any potential panic. But there are some ways to do this which actually are reassuring -- like laying out the odds that a random person on your bus has ebola in the first place, times the low chances of transmission even if he sneezes on you.

And then there is the way Frieden does it, which is full of misstatements, misleading claims, and general bullshittiness. Remember this erratic interview with Sanjay Gupta?

He's not giving you the facts from which you can draw your own conclusions.

He's instead giving you only conclusions, and supporting them with "facts" which are not in fact facts.

His conclusions are probably right, mostly. But he keeps misstating the actual science in order to support those conclusions.

This would just be a matter of Style Points -- and I'd say no big deal -- were it not for something else.

I would not be alarmed about ebola if I thought Doctor Tom Frieden were alarmed on my behalf.

I would not be worried about outbreak if I thought our professionals were worried enough about outbreak that they didn't need any additional worry on my end.

But their actual attitude -- not just the PR spin they offer the public to "reassure" them -- seems to be not alarmed at all.

It seems to be lackadaisical.

We have learned the following:

Frieden assured us that our medical professionals had been well-trained and drilled in epidemic response protocols. They were not well-trained and drilled. Per the Nurses Union, they had a brief video seminar and did not understand the protocols and actually had different versions of the protocols, which they followed at their whim.

Frieden assured us that the first infected nurse must have "breached protocols." Sanjay Gupta demonstrated that the protocols themselves are flawed and inadequate -- and, in any event, were not followed by the barely-trained Dallas hospital staff anyway.

Frieden assured us that High Risk exposures were being "closely monitored." In fact, one High Risk contact, the second infected nurse, was permitted to board a plane -- twice! -- with the CDC unaware of this, it seems, until today.

Frieden assured us that temperature scans were enough to catch an ebola-infected passenger. We've had that disproven multiple times -- first by Thomas Eric Duncan flying in from Liberia, then by this second nurse, who boarded a plane even with a "low grade fever" of 99.5 degrees.

Frieden then assured us that this symptom of ebola -- which she has now been diagnosed with -- was "not symptomatic" of ebola, so we shouldn't worry. Perhaps he meant "she wasn't sneezing and coughing, so she wasn't infectious."

Fine. But he's the epidemiologist. He's the scientist. Why can't he use the proper words?

Now today we find out the CDC is going to ban people who are High Risk for ebola from taking flights.

I think the nation, as a whole, assumed we were doing this obvious thing already.

I am very un-reassured to discover that this has just come across Tom Frieden's personal To Do list.

Frieden has done some good work, it seems, in reducing infectious disease (tuberculosis) in India.

But I am baffled at this man's reactivity and passivity in the face of a serious public health threat.

He seems to just want to reassure the public, and hope the problem just sort of sorts itself out without much of his involvement.

Which reminds me an awful lot of our President.

So maybe I shouldn't be baffled that Frieden is now passive, reactive, and determined to do only the bare minimum once the public starts howling.

Maybe that's his job now, as he understands it.

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posted by Ace at 06:52 PM

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