Information provided by Health Train Express and Digital Health Space is informational only. We do not endorse specific solutions. Inclusions are provided as reference only. Readers should consult with their own consultants for further details.

Wednesday, October 29, 2014

Ebola, Quarrantine Measures, Politics or Science ? Are the politicians correct?

Politics and Junk Science

The world is not a safe place.  (the truth will set you free?)

The United States has been especially fortunate because of the CDC and it's experience in endemic and epidemic infection. Many third world endemic infection have been controlled, and we have required immunization for diseases prevalent in other countries.

The advent of modern transportation with thousands of people travelling around the world in a matter of hours increases the importance of isolating and containing diseases such as Ebola.  Prevention is less expensive, and treatment on site at the origin of the endemic outbreak is essential.

In areas where endemics occur the population density and the prevalence of the infection increases the liklihood of spread to other locations.

The outbreak of Ebola is a mere test of our CDC's control methods. Far worse could be forthcoming. Politicians are making decisions without accepting recommendations from public health scientists and authorities.  Could they be correct ? The Governors of New York, New Jersey and others have correctly used their authority to protect the public health.

As usual our government reacts slowly.

The major effect has been for  health workers returning from West Africa. Health officials have emphasized repeatedly that direct contact with secretions is required for transmission to non-infected individuals.

This week's NEJM (New England Journal of Medicine) has several articles regarding Ebola, regarding diagnosis, treatment and isolation measures.

Ebola in the United States:  EHRs as a Public Health Tool at the Point of Care    
Ebola and our fragile health system

Despite repeated assurance by the CDC that the transmission of Ebola Virus is not airborne, there are recent articles which report vomitting produces a spray pattern, and protective measures to prevent spread of Ebola Virus.

Ebola Virus Disease and the need for New Personal Protective Equipment.

Ebola, the world's most dangerous virus. (documentary)

Numbers below are time tags and contents of video:

0:00 Introduction to viruses
1:20 Virus anatomy
2:35 Hemorragic fever in Angola (Ebola)
2:56 WHO and GOERM
3:15 WHO and world wide  monitoring
8:25  Infection control and prevention in underdeveloped countries
11:54 CDC
12:00 Biological containment and isolation methods
13:15  Ebola, Marburg virus have no treatments or vaccines. 

25:00 Virology, methodology for research
33:00 Viral Vectors and origins, zoonoses, West Nile Virus
36:00  Threat of bioterrorism
41:00  Limited resources, requiring large volunteer efforts in Africa and elsewere.
45:00  Previous lessons from HIV (25% of Africans had HIV virus leading to AIDS)

Ebola Virus Outbreak 2014 - WARNING

Ebola is named for a river in the Congo where virus first appeared in 1976.

This video is from an active Ebola facility in Western Africa and explains the isolation and containment methods used.

22:23 Health worker evacuation to U.S for treatment.

Experimental Treatment: ZMAPP 

Q: What is this drug?

A: Called ZMapp, it is a cocktail of specially engineered antibodies designed to target and inactivate the Ebola virus.

Q: What do we know about whether it works?

A: Very little. Various antibodies have been tested in small numbers of monkeys, but not people. In one study, 43 percent of treated monkeys survived when the drug was given after the animals showed symptoms.

Mapp Biopharmaceutical now is developing a combination of three antibodies that seemed most promising in those animal studies.

Ebola - What You're Not Being Told  according to reports from Scientific Reports; 

Are you as confused as I am? My education and training in medicine should make me able to discern fact from fiction.

Here are opposing views:

You'll notice if you read virtually any mainstream article on the topic that they make a point of insisting that Ebola is only transferred by physical contact with bodily fluids. This is not true, at all.
study conducted in 2012 showed that Ebola was able to travel between pigs and monkeys that were in separate cages and were never placed in direct contact.
Though the method of transmission in the study was not officially determined, one of the scientists involved, Dr. Gary Kobinger, from the National Microbiology Laboratory at the Public Health Agency of Canada, told BBC News that he believed that the infection was spread through large droplets that were suspended in the air.
"What we suspect is happening is large droplets; they can stay in the air, but not long; they don't go far," he explained. "But they can be absorbed in the airway, and this is how the infection starts, and this is what we think, because we saw a lot of evidence in the lungs of the non-human primates that the virus got in that way."

Translation: Ebola IS an airborne virus. (as is annotated in the video and below, I am using this term in the layman's sense as TRAVELS THROUGH AIR)
Someone pointed out that in medical terms, if the virus is transferred through tiny droplets in the air this would technically not be called an "airborne virus". Airborne, in medical terms would mean that the virus has the ability to stay alive without a liquid carrier. On one hand this is a question of semantics, and the point is well taken, but keep in mind that the study did not officially determine how the virus traveled through the air, it merely established that it does travel through the air. Doctor Kobinger's hypothesis regarding droplets of liquid is just that, a hypothesis. For the average person however what needs to be understood is very simple: if you are in a room with someone infected with Ebola, you are not safe, even if you never touch them or their bodily fluids, and this is not what you are being told by the mainstream media. Essentially I am using the word "airborne" as a layman term.
The AP's spin on it:
Experts say people infected with Ebola can spread the disease only through their bodily fluids and after they show symptoms.
From CNN:
Ebola spreads through contact with organs and bodily fluids such as blood, saliva, urine and other secretions of infected people.
And from the BBC itself in their article describing the second confirmed case in Nigeria:
The virus spreads by contact with infected blood and bodily fluids - and touching the body of someone who has died of Ebola is particularly dangerous.
To make matters worse, there is something very, very important that the corporate media and public health officials are not telling you regarding this crisis.
You'll notice if you read virtually any mainstream article on the topic that they make a point of insisting that Ebola is only transferred by physical contact with bodily fluids. This is not true, at all.

Sunday, October 12, 2014

How Obamacare will effect this year's Medicare Enrollment Period

How to judge Medicare plans

While much of the nation is preoccupied with Obamacare and picking new health insurance at work, older Americans have deadlines of their own coming up — involving Medicare.
We're just a few days away from the two-month period when the nation's 54 million Medicare beneficiaries have a chance to change their Medicare Advantage and prescription drug plans.
Every year, seniors should review their options and compare plans even if they're happy with their current coverage. Experts want people to avoid being surprised after it's too late to change. The deadline is Dec. 7.
"It's the same advice we give every year, but it's hard to get people off the dime," says Ross Blair, senior vice president of, which provides tools and information on Medicare insurance issues.

Medicare Advantage plans. Nearly 16 million people — or about 30% of the Medicare population — are enrolled in Medicare Advantage plans. These cover hospitalization, outpatient care and, often, prescription-drug coverage under one plan.
According to the Centers for Medicare and Medicaid Services, the average premium for Medicare Advantage plans will increase less than $3 next year, to $33.90 per month. Residents of Los Angeles County will see average costs of just $13.74 per month. The vast majority of enrollees will face little or no premium increase for next year.
 But out-of-pocket costs, such as deductibles and co-pays, are expected to rise. Looking beyond the monthly premium will be important for shoppers wanting to save money.
Be aware that some Advantage plans will be terminated this year. Be certain yours will continue;
Pay attention to networks, experts stress. Medicare Advantage plans are also reducing the size of their provider networks — in some cases quite dramatically.
If your physician will no longer be participating in your current plan, your insurer is required to send you notice of that fact and help you find another doctor in the network.
Nationwide, the average monthly premium in 2015 will be about $31, the federal government estimates. In California the figures vary, but the average is $58.91.
Although the number of these plans has dropped for 2015, there will still be 1,000 available nationwide. In Los Angeles County, Medicare participants will have 31 plans from which to choose for 2015, down from 34 this year.
Also, pay attention to the ratings. To help consumers determine the value of both Medicare Advantage and prescription drug plans, Medicare created a quality rating system. A plan can receive one to five stars, with five being the best, based on the agency's assessment of medical services and customer satisfaction.
Experts urge consumers to be alert for possible changes since last year's Medicare Advantage and prescription plans.
To review your plan options: Medicare plan finder at http://www.medicare.govor call (800) MEDICARE;
For free personalized counseling services: State Health Insurance Assistance Programs, or call (800) 677-1116; In Los Angeles, California Health Advocates: