Friday, October 24, 2014

Close to Home

NYC didn't used to be close to home to me. It was a far-distant, strange, and very uncomfortable place, profoundly dedicated to things that are as foreign to me as Cairo and I don't mean Cairo Durham.

I still have enough fingers to count the number of times I have been there and won't run out any time soon. It is not where I go to have fun and frolic, being much more concerned with chickadees and real cowboys than with chic and the naked one that runs around down there.

However, since our boy and my dear brother work there most of the time, it is suddenly, far too close for comfort.

When are the powers that be in this sad relic of America going to do something meaningful about stopping the plague from shlepping in on a plane or trotting across the desert to visit?

I don't normally do this, and won't in the future, but here is a Farm Side (you can read the Farm Side every Friday here if you wish to) I wrote recently:

Biosecurity matters on dairy farms. Farms often welcome visitors for various reasons and it is paramount that they don’t bring disease along with them.

Out of respect for the health of farmers’ valued herds of cattle, veterinarians, milk inspectors, salesmen, and people visiting for educational tours willingly wash their boots with disinfectant before entering. Often they add those awkward, slippery, one-size-really-doesn’t-fit-anybody, plastic booties that are pulled on over footwear, before shuffling ignominiously through someone else’s barn.

I remember them from tours, clinics, and classes we have taken and barn meetings we have attended, and not one bit fondly either.

On many larger farms visitors are not even allowed in animal areas without a specific invitation. Then they are expected to respect the farm’s biosecurity practices. Some of the contagious diseases that affect animals can cause economic devastation, so farmers and animal care professionals work hard to prevent them spreading from farm to farm.

Sometimes these precautions seem like a pain in the neck, but animal health is a keystone to good management strategy.

On hog farms protocols are even more stringent than they are on dairies. The University of Nebraska at Lincoln lists 28 pages of recommendations to keep pigs safe from outside diseases. Suggestions range from washing the wheels of vehicles to isolating incoming animals in quarantine until they are clearly seen not to harbor disease.

It is recommended that even the clothing worn by workers be worn only in the barn where the work is done and washed onsite. Many barns require workers to shower before entering or leaving.

Risk assessment of visitors is suggested, with people who visit other farms or own animals considered high risk and treated differently from those who have no animals and visit no farms.

If visitors are allowed at all, they are often required to shower, or to remove shoes, hats and outer clothing and leave them in a designated room. Then they must walk over a grate, wash thoroughly, and don clothing provided by the farm.

In light of the recent appearance of porcine viral diarrhea in the US, many farms have banned visitors altogether.

As you can see, farmers understand clearly the potential for disease to spread among different populations of animals and they take great precautions against allowing dangerous microorganisms  entering their premises.

Now imagine that the USA is a giant farm full of valuable mammals. In this case their worth to their families and friends goes far beyond that of food-producing animals. PeTA may think a rat is a pig is a dog is a boy, but most of us see our loved ones quite differently.

So, why on earth do we as a nation not take every possible step to protect our families from foreign disease, at least half as assiduously as farmers protect our bacon?

Biosecurity needs to be addressed at the national level in regard to human disease at least as diligently and intelligently as farmers pursue it at their farms.

Of course I am referring to the recent diagnosis of the dreaded disease, Ebola, in Texas.

We can’t just let death walk off a plane and wander willy-nilly among our children, without protective clothing, without isolation, without much of any oversight at all. We are used to our freedoms, including the freedom to travel at will, and we are happy to share these with anyone who stops by for a visit. However, the anarchy of deadly disease does not equal freedom.

Hog farmers quarantine incoming hogs until they are clearly free of disease. If we are to continue to allow visitors from affected regions to come here, maybe quarantine would help protect our families.

We didn’t used to be afraid of it. During the polio epidemics of the twentieth century homes were routinely placed under quarantine, and the restrictions were strongly enforced. In 1909 violators were fined one hundred dollars, a small fortune in those days. You could buy a horse for seventy during that decade. Quarantine was widely used even against self-limiting diseases, such as measles, wherein patients were required to stay at home until no longer infectious.

Granted the family of the Ebola victim was placed under quarantine, but they quickly violated this and left their home. Meanwhile, according to the Guardian Newspaper, “At midday on Thursday, a child peeked out from behind a red diamond-pattered curtain in one of the apartments while at ground level a team of three contractors – none wearing any sort of protective clothing – power-washed the front porch. A stroller stood at the bottom of a staircase.”

Yep, you have to shower and change your clothes to visit a pig farm, but you can clean up toxic medical waste with a tool that creates airborne particles in large numbers, wearing jeans and a sweatshirt, and then go home to your family.

Mistakes are being made and excuses offered. Somehow I feel as if a nation as advanced as ours should have been prepared and now that the disease is here and in danger of spreading, should take whatever steps are needed to stop it in its tracks.

Flight restrictions, increased monitoring of incoming foreign flights, strictly enforced quarantines of people who are exposed should careful oversight of their health prove inadequate, all should be considered.

The thought of our military being sent with scant training, into the firestorm boggles my mind. Doctors taking full precautions are getting sick. How will thousands of military workers be protected?

Concern for the safety of our people should come first. If farmers can do it, then it can surely be done if the will is there. 58% of Americans are in favor of temporary flight restrictions to and from epidemic areas in Africa. Although authorities claim that such actions might interfere with aid flights, American safety should matter more. It is too early to tell how Ebola will affect us, but hopefully it is not too late to institute measures that could have prevented this man from wandering among us, possibly spreading this plague.


Afterword, I believe that many of these numbers have changed since this was published. People want travel stopped or at least a lot better controlled. I never thought I would be glad that my boy is in Washington and not NY, as the drive when he wants to come home is ridiculous. However, until the nation gets serious about stopping Ebola, I will be glad that he is anywhere that it isn' to worry about my brother....and millions of other innocents.....


Bill Harshaw said...

The way I see it, so far the only Americans to have caught Ebola were caring for an Ebola patient. Even the people who lived with the Ebola patient for several days didn't catch it. So even though it's a more serious disease once caught, it's nothing like as contagious as polio, mumps, or measles, to cite bygone diseases, or even flu of today, which kills more Americans, or the diseases like the pig virus killing 10 percent of the nation's piglets.

Anonymous said...

I agree completely. There are plenty of required things we farmers do to stop disease and this is no different!

Cathy said...

It's insane. We saw a video this morning of two men who'd gone into the NYC's doctor's apartment to decontaminate it. My God! They took off their biohazard outfits and stuffed them into a public wire-meshed trash basket on the curb in front of the apartment !!!!!!!!

jan said...

So much that we are told makes no sense or the next day shown to be wrong. How is it that a patient can give the disease to someone on a bus but we can't catch it on a bus?

Cathy said...

I guess it wasn't an entire Hazmat suit. Just the gloves and masks.

June said...

"This is not influenza or measles,” says Paul Offit, the Chief of the Division of Infectious Diseases at the Children’s Hospital of Philadelphia. “It’s not spread by the respiratory route. If you’re sitting next to someone on a plane, you’re not going to catch it. People should take note of the fact that Duncan’s family never got sick.”

threecollie said...

Bill, we have only had a couple of cases and those have received the full attention of authorities and medical professionals. What happens if enough cases occur to overwhelm our medical system? Financially alone it would be a disaster. Nurses who had the best protection available to them got sick. This is not something to toy with.

Anon, exactly

Cathy, we have been so lucky that more people haven't become ill as cavalier as many responders have been.

Jan, I am not filled with trust. And good friends in the medical profession aren't either.

June, nevertheless, there is no reason to let people who are potentially contagious come here and run around willy nilly. Governor Cuomo has finally done something right requiring mandatory quarantine for people coming here who have been in contact with the disease.

Uta said...

When I came to this country in 1956 we had to be screened for deceases and get various shots before we could enter the country.Why are we so lacks now?

Bill Harshaw said...

Doctors Without Borders has had 700 healthcare workers return from west Africa to their home countries with no cases of Ebola.

No Americans have died of Ebola, none of the contacts being traced from the Duncan case or the other scares has ever come down with Ebola.

I'm too old to get wrapped up in media-fed panics like the ones I've seen in the past: Alar, West Nile, swine flu, H1N1, SARS, swine flu, all overblown.

threecollie said...

Bill, your privilege. I will remain deeply concerned. I have been following the Ebola story since I first heard of it, which was a very long time ago, and writing about since it popped up in chimps in Virginia in the 90s. We are certainly better equipped to handle it than poor West African nations, but as long as my good friends in the health care field are strongly concerned so will I be.

threecollie said...

Uta, sorry I forgot to answer your comment. I completely agree with you. We can't afford to be casual about deadly diseases