Sunday, October 26, 2014
I've Got Flu, Not Ebola
I'll post in a bit when I recover a bit. In the meantime, it appears as if the CDC nurse who is outraged that anyone would dare to quarantine her is part of the new Center for Disastrous Complacency. Are these people nuts?
This woman is actually having hysterics in print because when the non-contact temp scanners used in the new screening protocol registered a high temp, they followed their own protocol? She's nuts, right? Or perhaps she's a smoker and is having the most publicly neurotic nicotine fit of the year? WTF? Ask for a nicotine patch, you bimbo!
Well, Christie and Cuomo did the only rational thing, thus earning the nearly 100% support of the doctors and nurses who actually treat people, but the outrage and disdain of the Centers for Disastrous Complacency and all the Kool Kidz.
The Center for Disastrous Complacency has now lost its street cred among the working medical crew. I miss the days when that outfit was about controlling infectious disease, but it's clearly not about that any more and hasn't been for some time.
In the meantime, the danger of this thing getting out and about in the US increases week by week. Call your Congressman and ask for a policy of an automatic three-week supervised quarantine for all travelers originating from countries with sustained lines of transmission, with antibody testing on the 20th non-symptomatic day, followed up by further detention if one is positive. And some will be. The reason TPTB don't want to do this is that they expect sustained lines of transmission in the US. Well guess what, our current course is how to get there. These loons must be stopped.
If we get sustained lines of transmission in the US, other countries need to shut us down. We do not want to go down in history this way.
Ebola will spread MUCH faster in the US than it will in Africa, because we have such broad access to medical facilities. There are non-detected infectious people spreading it through the non-Ebola treatment wards there. The same will happen here.
The only way to eventually control the situation here will be to have widespread testing. We don't currently have the ability to do it, so quarantine is the only option.
"Direct Contact" doesn't mean what the public thinks it does. Remember this in 2011? That's direct contact for Ebola:
An investigator swabbed high-traffic areas, including countertops and the handles on the self-serve milk dispensers. All had received a grade of “A”—the highest rating given by inspectors with the City Department of Health and Mental Hygiene. Specimens were sent to Philip Tierno, director of Clinical Microbiology and Immunology at New York University Langone Medical Center. About half were contaminated with “fecal organisms.”The early symptoms of Ebola are not easily distinguished from other viral illnesses, and milder cases will never be picked up at all. It's likely that low levels of the virus will be shed from tears (runny eyes), transferred to people's hands, and passed on that way.
Samples taken from milk containers in three separate Starbucks stores tested positive for traces of Enterococcus, fecal strep, E. coli, and Klebsiella.
Well, I would love to hear the conversation between Christie, Cuomo and our Dear Leader. One suspects it might get a bit "Sicilian".
Sunday, October 12, 2014
I've About Had It With Race Mongers
Yesterday Jesse and the Duncan family gave a press conference saying Duncan didn't get the right treatment for racial reasons. They wanted him flown to either Emory or Nebraska.
Well guess what - Duncan got all sorts of measures you and yours ain't gonna get, because CDC just changed their guidelines to "avoid AGPs". This means that if you get sick, you aren't going to get ventilation, intubation, or kidney dialysis unless you get very, very lucky. CDC also recommends keeping labs to the absolute minimum. You'll be lucky to even get an IV. It's more likely that when you get really sick they'll tie you to the bed and roll you into the dying ward. They may give you some liquid morphine if you are able to swallow.
I told my family a while ago to prepare for home care if this thing takes off, and that's where we are. We're working on a possible protocol at the clinic. If this gets out, hospitals are unlikely to be a good bet. It's been very clear that Ebola virus has been spreading through the clinics in the affected countries, and it will here too. That Dr. Sacra was working in a maternity ward totally separated from any Ebola cases. And he was an experienced missionary doctor. He still got infected. Which matches perfectly with our experience here and in Spain. You need special wards and special equipment to safely treat these people, and we don't have them in any quantity.
Why are we letting people come in from affected countries? I have no idea. The doctors I know are appalled and amazed at what's happening.
What are the chances that it gets out? Well, unless the affected countries are locked down quickly, very good!
Here's where the open southern border is a killer. If you don't let people in through the air, they can just fly to some South American country and come in over the southern border. If they do, before long it's in South America. What are our chances if this gets out dwn there? Very poor.
Anyway, preparing for rolling quarantines is a good idea. I noticed the local supermarket started being unable to keep the bleach stocked last week. I'm sure it is health care workers and their families buying it. So get yours while you still can.
The problem with containment is that there are carriers. If you get a small viral dose, you may not get overtly ill. But you can still be infectious with intimate contact.
So all bets are off. Bullets and bleach and gloves. That's the ticket. If you think I'm joking, you're wrong.
The reason I've been talking to my family about this already is that a few weeks ago, the clinic started getting calls from the African immigrant families who are patients. They all had relatives who were visiting and just wanted to come in for tests. Unspecified. Needless to say, we did not take them.
The only way you can get tested for Ebola exposure is to go to a hospital, but if you are not symptomatic you are not going to get tested. We've referred several regular patients who believed they might have been exposed, but they aren't getting tested. It's probable that we already have four or five carriers in the country. God help us if one of them tries to make a living as a prostitute.
Bullets, bleach, gloves, masks, chastity and prayer. That's the ticket.
I am bitter, because I think there is a good chance I will get killed by the whacky sort of wishful thinking that has governed the decision making in this country for some time. I was making huge progress with what I was doing. I'm not going to quit, because the clinics have to stay open, but it's not a good bet.
We saved two absolutely terminal patients this last year, and dramatically improved medical status of many more using this method. So I'm not going to quit. But I sure will die pissed as hell if I get killed before I get a chance to formalize this and dump it out there.
If you know a doctor, start being nice. REALLY NICE.
Wednesday, October 01, 2014
So, October Data Begins
The earliest time when I could meaningfully update that forecast would be late in October, as we got a read on the rolling impact of price changes and attempts to adapt. Well, it is October. As I get 'em I will try to post 'em.
The first read is CMI covering September. Published yesterday, it showed a hard fall in credit indicators for manufacturing, with the weakness concentrated in the unfavorable factors. This is the one I have been watching most closely, because it leads other indicators by several months. I expected it, it is not dire, and we are not yet in the realm of spiraling negative correlations, but it is certainly not encouraging. Some of the words used in the narrative were "collapse", "not a small reversal of fortune", "almost shocking", and "intense concern".
Services didn't improve either, but the problem is much milder. Is it an adjustment? I don't know and I don't think anyone can tell right now. It's very possible that over the next few months this could clear through and growth could continue on a somewhat lower trajectory.
So far this has been pretty classic, with credit standards loosening as everyone attempts to keep the wheels of commerce greased. The sole very definite thing one can say about yesterday's CMI (I'm not sure if we are allowed to link it any more), is that the negatives are harsh enough that credit issuance is going to have to tighten. From there, it's anyone's guess.
The standard PMIs and so forth won't tell me much until about December. They are later in the sequence.
We do have some good things which may help to offset the difficulties of the last year. We also have some bad stuff. The fall in oil prices helps, food prices are still a strong negative, but that may be starting to fall out, rents are WAY too high (very intractable), forget the housing market, strong dollar is not a good thing for manufacturers, but strong dollar does attract some refuge money.
Ebola? Not a help. The CDC issued a guidance to funeral homes in the US, which made my heart stop. I feel no confidence there.There will be multiple arrivals in the US, and this first one was not handled in a way to generate confidence.
Europe looks to be in real trouble. The weaker Euro can help only over months, and Germany's Mittelstand is apparently now walking through mud. But the weaker Euro imposes costs on US manufacturers. As of August, the durables report showed a roughly balanced situation. But the dollar is too strong and the international situation too difficult for this to continue.
Transportation (ATA truck tonnage and rail) have been showing strength. The weakness is all in consumer finances.