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Obama picks EBOLA Czar.... medical superstar?

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  • #46
    Originally posted by Teallaura View Post
    This is where you and Sam are making the same mistake. Sam because he mistakenly believes patients won't lie when it is in their best interest to tell the truth (I've had people take a full series of not fun penicillin shots rather than admit they had sex within the last year. Can't count the number of 'virgins' with symptomatic syphilis I've interviewed - it's total nonsense) and I'm not sure why you think so. A virulent contagion that transmits readily is EASY to lose control of - we lose control of syphilis which isn't nearly as virulent nor as easily transmitted. Every epidemic begins with a single case. While it is too early to jump at shadows, it's foolishness to believe that there is no chance of this stuff getting loose. Thus far it's been amateur night at the CDC corral - that alone should give people cause for concern.
    That's a valid criticism; allow me to explain my thought there:

    Lots of people lie against their best interests. Not so many lie against what they perceive to be their best interests. A good number of people will make a somewhat-rational determination that preserving the image of chastity is more important than a quick recovery of a STD — fewer would face a doctor telling them that the difference between life and death in the next week depended on an honest statement about recent sexual activity and lie. In the case of Ebola, there is no gain whatsoever for lying; not only would the person require admittance to the hospital in any case, his life would very likely depend on immediate treatment. Notably, Thomas Duncan, the Liberian patient who died in Texas, lied about his potential exposure to Ebola when flying to the US but not when he went to hospital with symptoms.

    I think it's safe to say that someone suffering from Ebola-like symptoms who knows that she has been in possible contact with an Ebola victim has little to no risk of lying about that fact. It's not only against her best interests but also against her perceived best interests.
    "I wonder about the trees. / Why do we wish to bear / Forever the noise of these / More than another noise / So close to our dwelling place?" — Robert Frost, "The Sound of Trees"

    Comment


    • #47
      An interesting article from New York Times.

      Source: NYT

      When you think about it, many of the Obama administration’s “scandals” have been failures of competence. The Secret Service let a man leap over the White House fence and get into the White House. The Veterans Health Administration covered up unconscionable delays in treating veterans. The error-ridden rollout of the Obamacare website was a nightmare for people trying to sign up for health insurance. The Republican right takes it as an article of faith that the national government can’t do anything right. Problems like these only help promote that idea.

      And now comes the C.D.C. — the most trusted agency in government — thrust in a role for which it was designed: advising us and protecting us from a potential contagion. With every new mistake, it becomes, in the public eye, just another federal agency that can’t get it right.

      © Copyright Original Source

      The first to state his case seems right until another comes and cross-examines him.

      Comment


      • #48
        Originally posted by Sam View Post
        In the case of Ebola, there is no gain whatsoever for lying;
        I'm at the airport getting ready to board a flight for the US where I hope I can get treatment for this incredibly horrible disease, and they ask me a bunch of questions that would prevent me from boarding the plane. NATURALLY, I'm just going to tell the truth and accept the consequences.
        The first to state his case seems right until another comes and cross-examines him.

        Comment


        • #49
          Originally posted by Sam View Post
          That's a valid criticism; allow me to explain my thought there:

          Lots of people lie against their best interests. Not so many lie against what they perceive to be their best interests. A good number of people will make a somewhat-rational determination that preserving the image of chastity is more important than a quick recovery of a STD — fewer would face a doctor telling them that the difference between life and death in the next week depended on an honest statement about recent sexual activity and lie. In the case of Ebola, there is no gain whatsoever for lying; not only would the person require admittance to the hospital in any case, his life would very likely depend on immediate treatment. Notably, Thomas Duncan, the Liberian patient who died in Texas, lied about his potential exposure to Ebola when flying to the US but not when he went to hospital with symptoms.

          I think it's safe to say that someone suffering from Ebola-like symptoms who knows that she has been in possible contact with an Ebola victim has little to no risk of lying about that fact. It's not only against her best interests but also against her perceived best interests.
          Presumes people will a) consider the disease a higher priority than the X factor that inclines them to lie and b) that they will behave rationally. In my professional experience, neither of those can be relied upon. I have an HIV pt now who is convinced a cure is around the corner. I've had a few over the years decide they didn't have HIV any longer - despite all evidence to the contrary. These being otherwise functional or mostly functional adults. Once they become fixated/convinced, you cannot rely on their rationality. They are, sadly, acting rationally but they are basing their decisions on their delusions. I see the same thing happen with syphilis but much less severely - the difference seems to be their fear. HIV is terrifying; syphilis, being curable, is not. I fully expect ebola contacts to behave more like HIV contacts than syphilis contacts for exactly the same reason. Never underestimate the power of the human mind to deny reality.
          "He is no fool who gives what he cannot keep to gain that which he cannot lose." - Jim Elliot

          "Forgiveness is the way of love." Gary Chapman

          My Personal Blog

          My Novella blog (Current Novella Begins on 7/25/14)

          Quill Sword

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          • #50
            Originally posted by Cow Poke View Post
            I'm at the airport getting ready to board a flight for the US where I hope I can get treatment for this incredibly horrible disease, and they ask me a bunch of questions that would prevent me from boarding the plane. NATURALLY, I'm just going to tell the truth and accept the consequences.
            Again a misinterpretation of a thought that could have been avoided by simply blockquoting the entire relevant thought. I can't tell if y'all just read up to a certain point and freak out or if you read the entire thought and simply omit the points that would make your post seem silly.

            The point at issue was a symptomatic person lying to medical personnel at the hospital, not asymptomatic persons lying to gain entry to the US. This was easily inferred just by reading the preceding and following sentences.
            "I wonder about the trees. / Why do we wish to bear / Forever the noise of these / More than another noise / So close to our dwelling place?" — Robert Frost, "The Sound of Trees"

            Comment


            • #51
              Originally posted by Sam View Post
              Again a misinterpretation of a thought that could have been avoided by simply blockquoting the entire relevant thought.
              Be more succinct. For cryin' out loud, I think you're trying to exceed Spart in verbosity!

              I can't tell if y'all just read up to a certain point and freak out or if you read the entire thought and simply omit the points that would make your post seem silly.
              You bloviate far too much --- just say what it is you want to say.
              The first to state his case seems right until another comes and cross-examines him.

              Comment


              • #52
                Originally posted by Teallaura View Post
                Presumes people will a) consider the disease a higher priority than the X factor that inclines them to lie and b) that they will behave rationally. In my professional experience, neither of those can be relied upon. I have an HIV pt now who is convinced a cure is around the corner. I've had a few over the years decide they didn't have HIV any longer - despite all evidence to the contrary. These being otherwise functional or mostly functional adults. Once they become fixated/convinced, you cannot rely on their rationality. They are, sadly, acting rationally but they are basing their decisions on their delusions. I see the same thing happen with syphilis but much less severely - the difference seems to be their fear. HIV is terrifying; syphilis, being curable, is not. I fully expect ebola contacts to behave more like HIV contacts than syphilis contacts for exactly the same reason. Never underestimate the power of the human mind to deny reality.
                That's true. So what factors do you think would compel a person to lie about Ebola infection? An HIV+ individual who believes a cure to be available soon has a strong disincentive to undergo costly or onerous treatment so long as she believes the cure will arrive before any really bad symptoms set in. An Ebola patient, by contrast, knows that living through the next 10 days very likely depends on getting treatment as quickly as possible. There isn't the same cost/benefit ratio that would lead a person to lying. I do agree that many Ebola patients will disregard advice to avoid unprotected sexual activity or breastfeeding for 90 days during convalescence: there we would find a place for motivated reasoning to trump clear best interest perceptions. But it seems extremely unlikely that we will see people who know they've been in contact with Ebola and showing symptoms lying about that . . . in fact, we're currently experiencing the opposite, where infected individuals are being forthright about their possible contact.
                "I wonder about the trees. / Why do we wish to bear / Forever the noise of these / More than another noise / So close to our dwelling place?" — Robert Frost, "The Sound of Trees"

                Comment


                • #53
                  Originally posted by Cow Poke View Post
                  Be more succinct. For cryin' out loud, I think you're trying to exceed Spart in verbosity!

                  You bloviate far too much --- just say what it is you want to say.
                  If I say less then I leave the door open to misinterpretation when people don't think through the implicit parts of my argument. So I say more in order to make those connections explicit. It's useful, because folks like you and Paprika end up misinterpreting anyway and I can point out that spending a couple more minutes reading my posts would help you avoid such errors. And when I find that my posts are selectively edited such that those points contradicting the misinterpretation are suddenly gone, you have to forgive the thought that such editing might be intentional or, at least, a product of a filtering bias.
                  "I wonder about the trees. / Why do we wish to bear / Forever the noise of these / More than another noise / So close to our dwelling place?" — Robert Frost, "The Sound of Trees"

                  Comment


                  • #54
                    Originally posted by Sam View Post
                    That's true. So what factors do you think would compel a person to lie about Ebola infection? An HIV+ individual who believes a cure to be available soon has a strong disincentive to undergo costly or onerous treatment so long as she believes the cure will arrive before any really bad symptoms set in. An Ebola patient, by contrast, knows that living through the next 10 days very likely depends on getting treatment as quickly as possible. There isn't the same cost/benefit ratio that would lead a person to lying. I do agree that many Ebola patients will disregard advice to avoid unprotected sexual activity or breastfeeding for 90 days during convalescence: there we would find a place for motivated reasoning to trump clear best interest perceptions. But it seems extremely unlikely that we will see people who know they've been in contact with Ebola and showing symptoms lying about that . . . in fact, we're currently experiencing the opposite, where infected individuals are being forthright about their possible contact.
                    Block quote. Ya HAPPY?

                    So, what about a person who wants to get to a really good hospital that's set up for the best treatment. What would keep them from lying at Podunk Hollow Airport to board a plane to get treatment in Shining Light Hospital? I mean, we all want the BEST care, especially with such grave consequences!
                    The first to state his case seems right until another comes and cross-examines him.

                    Comment


                    • #55
                      Originally posted by Sam View Post
                      And when I find that my posts are selectively edited...
                      Please forgive me for selectively QUOTING from your block of text, but in all honesty, nobody is "editing" your posts, Sam.

                      I mean, heck, sure, I do that ACCIDENTALLY when I use the "edit" function as a moderator, and catch holy heck from my peers for it, but copying PORTIONS of your posts is not "editing" them.

                      Otherwise, you made some good points, and I'll try to be more charitable.
                      The first to state his case seems right until another comes and cross-examines him.

                      Comment


                      • #56
                        Originally posted by Sam View Post
                        That's true. So what factors do you think would compel a person to lie about Ebola infection? An HIV+ individual who believes a cure to be available soon has a strong disincentive to undergo costly or onerous treatment so long as she believes the cure will arrive before any really bad symptoms set in. An Ebola patient, by contrast, knows that living through the next 10 days very likely depends on getting treatment as quickly as possible. There isn't the same cost/benefit ratio that would lead a person to lying. I do agree that many Ebola patients will disregard advice to avoid unprotected sexual activity or breastfeeding for 90 days during convalescence: there we would find a place for motivated reasoning to trump clear best interest perceptions. But it seems extremely unlikely that we will see people who know they've been in contact with Ebola and showing symptoms lying about that . . . in fact, we're currently experiencing the opposite, where infected individuals are being forthright about their possible contact.
                        The reasons are as varied as individuals. Not all contacts are mentally healthy or even competent so you can not rely on C/B to be rational. Even the ones that are may find their X factor to be more compelling than the disease despite all attempts to convince them otherwise - I see this a lot. Not every contact will trust authority - and most regard doctors as authority figures. The list goes on and on.

                        Presuming rationality despite 50 years of multiple disciplines seeing the exact opposite (you wouldn't believe how many TB patients decide they are cured and stop taking meds)is unwise. It is better practice to assume the patient will lie and insert questions in your triage to try and catch those potential contacts (fortunately, most stink at lying - they assume they won't be challenged and are easy to trip up).
                        "He is no fool who gives what he cannot keep to gain that which he cannot lose." - Jim Elliot

                        "Forgiveness is the way of love." Gary Chapman

                        My Personal Blog

                        My Novella blog (Current Novella Begins on 7/25/14)

                        Quill Sword

                        Comment


                        • #57
                          Originally posted by Cow Poke View Post
                          Block quote. Ya HAPPY?

                          So, what about a person who wants to get to a really good hospital that's set up for the best treatment. What would keep them from lying at Podunk Hollow Airport to board a plane to get treatment in Shining Light Hospital? I mean, we all want the BEST care, especially with such grave consequences!
                          This seems to be getting into far-fetched hypotheticals. If that person is already symptomatic, what are the odds they'll be allowed on a flight? Probably pretty low. And we're not really talking about something like heart surgery, where there are clearly "BEST care" facilities. An Ebola patient at a regional hospital in Texas doesn't necessarily have access to worse care than somewhere else; so long as the appropriate protocol is followed, the mortality risk is going to be about the same. It's the isolation factor that was different between this case and the other cases and a person choosing a hospital on that basis wouldn't be getting on a plane.

                          If a symptomatic individual in the US hops a plane in order to be treated at a different hospital than one close by, I'll eat my hat. Until then, however, that's really a hypothetical situation that stands outside of plausible scenarios.
                          "I wonder about the trees. / Why do we wish to bear / Forever the noise of these / More than another noise / So close to our dwelling place?" — Robert Frost, "The Sound of Trees"

                          Comment


                          • #58
                            Originally posted by Cow Poke View Post
                            Please forgive me for selectively QUOTING from your block of text, but in all honesty, nobody is "editing" your posts, Sam.

                            I mean, heck, sure, I do that ACCIDENTALLY when I use the "edit" function as a moderator, and catch holy heck from my peers for it, but copying PORTIONS of your posts is not "editing" them.

                            Otherwise, you made some good points, and I'll try to be more charitable.
                            Thank you, though I don't expect to hang around much longer, anyhow. Epidemiology pulled me back in but I'm already spending more time than I'd like to and will likely be gone again soon.

                            By "editing," I am of course referring to the argument I'm making being edited, not the text. In the same way that quote-mining changes a person's argument to one more easily refuted, selectively quoting a person's thought by eliminating the whole thought — especially when the omitted portion explains the very thing being challenged —does not strike me as careful or appropriate debate etiquette.

                            But thank you for the charity; it is appreciated.
                            "I wonder about the trees. / Why do we wish to bear / Forever the noise of these / More than another noise / So close to our dwelling place?" — Robert Frost, "The Sound of Trees"

                            Comment


                            • #59
                              Originally posted by Sam View Post
                              This seems to be getting into far-fetched hypotheticals. If that person is already symptomatic, what are the odds they'll be allowed on a flight? Probably pretty low. And we're not really talking about something like heart surgery, where there are clearly "BEST care" facilities.
                              Pshaw.... I'm in a LOT of hospitals as a minister, Sam, and there are some I wouldn't recommend to ANY of my friends to seek treatment of ANY kind.

                              An Ebola patient at a regional hospital in Texas doesn't necessarily have access to worse care than somewhere else; so long as the appropriate protocol is followed,
                              And some hospitals do this better than others.

                              the mortality risk is going to be about the same. It's the isolation factor that was different between this case and the other cases and a person choosing a hospital on that basis wouldn't be getting on a plane.
                              The attitude toward the "isolation factor" might vary WILDLY from somebody who was trying NOT to get the disease, and somebody who felt they already had contracted it.

                              If a symptomatic individual in the US hops a plane in order to be treated at a different hospital than one close by, I'll eat my hat.
                              Try some meat tenderizer -- it might make it go down easier.

                              Until then, however, that's really a hypothetical situation that stands outside of plausible scenarios.
                              We have a local hospital that mostly the poor and uninsured go to --- most people who have good insurance would rather go to one of the hospitals 60 miles away. MANY smaller communities have local hospitals that don't have the staff or facilities to handle such a potentially dangerous disease, Sam.
                              The first to state his case seems right until another comes and cross-examines him.

                              Comment


                              • #60
                                Basics of contact tracing.

                                "He is no fool who gives what he cannot keep to gain that which he cannot lose." - Jim Elliot

                                "Forgiveness is the way of love." Gary Chapman

                                My Personal Blog

                                My Novella blog (Current Novella Begins on 7/25/14)

                                Quill Sword

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