Monday, October 27, 2014

Furor against Governors’ decision on quarantine. I am in the eye of the storm due to my 5 appearances on Sunday TV giving scientific reasons against blanket quarantine. 2 days ag, nurse returned to Newark from West Africa after taking care of Ebola patients. She got caught in the quarantine issue and was put in an old hospital tent in New Jersey and (as she says) was treated like a criminal/prisoner. Officials at airport initially thought that she had fever since they did a skin tem while she was flushed. Turned out she had no fever and ultimately tested negative. Christie looking real bad on this one. She is playing it out by suing and being very vocal that her human rights were violated. Ultimately, she was let go to drive to Maine to see her boyfriend. Cuomo now backing off a bit and leaning towards direct, active monitoring. CDC revising M and M document. Tom and I want the “direct” part of the monitoring to be able to be done by Skype or Face Time. However, Ron Klain thinks that the POTUS and Jeh Johnson want actual physical presence of monitor (health official, nurse, etc.). Trying to reconcile. Had important conversation with Jen Cohn of MSF Switzerland who kindly got on a teleconference reps from MSF of many countries (Brussels, Paris, Geneva) to discuss the RCT Ebola vaccine trial that Cliff is actively planning to start in Monrovia in December following completion of the Phase 1 trial that started in Maryland in Sept. (ChAd3) and Oct (VSV). Looks like MSF wants to be helpful. They are asking good questions about supply for post-trial distribution, etc. They seem to not be against an RCT. CDC came out with new interim guidelines for Monitoring and Movement of people (including HCWs) returning from West African Ebola countries. Now based a lot on what I and Tom have been articulating at the recent White House meetings. First stratification of risks to the person; and then matching the risk to the degree of monitoring and then using clinical judgment when needed to determine level of restriction. All based on knowledge of how virus is spread. Risks: high, some, low but not zero. Monitoring: passive – take your own temperature and sxs and no need to actively tell anyone; active – take your own temp and sxs and report to a health official; direct, active – someone else takes your temp at least 1x per day and evaluates sxs and then makes clinical judgment as to your restriction on a daily basis Immediately following their release of guidance and the press briefing by Tom Frieden, the White House put my out on all the evening TV shows that were either taped or live from studio in Building 10: PBS NewsHour; CNN Situation Room; ABC, CBS, and NBC Evening News.