>Clearly, there were mistakes, but I think one of the key things to notice here is that even after the hospital sent Duncan home with Ebola, the people he was living with didn't come down with the disease. That certainly says something about difficulty of transmission.
>
>
>Question, have the events of the last 24-48 hours (case in NYC) given you cause to reconsider?
>
>Certainly not about the difficulty of the transmission - without question, it's difficult to transmit. And as experts have said, even in the case of a highly infected person standing next to you and sneezing in your direction, there are physical respiratory barriers that still make it very unlikely.
>
>But that doesn't change some key problems....
>
>First, Dr. Spencer (certainly a courageous man who put his life on the line in Guinea) taking public transportation within the incubation period to go bowling....not what I would call responsible behavior and arguably not even demonstrating common sense. I'm going to speculate here, and you can disagree with me if you choose, but I have to wonder if this is pure arrogance/denial on the part of the doctor. Even the CDC states that those who are infected or believe they could be infected should not be taking public transportation.
>
>Couple that with a totally asinine explanation of a transcription error for the temperature, and it's reasonable to conclude that if health professionals can't be disciplined enough in their procedures, those with less understanding probably won't be either.
>
>Second, the NYC cops who sealed off Spencer's apartment were unaware of how to dispose of potential bio-hazardous material. There are verified pictures and videos of cops tossing gloves and masks into public trash cans instead of biohazard bags.
>
>It's irrelevant if Spencer is the only case from this recent situation (and I certainly hope he is the only case from it). Mistakes continue to occur that contradict the CDC's own recommendations/policies. We've a level 4 Pathogen that is likely to show up as more data points here (CDC admitting that 100 to 150 people from Ebola infected areas are entering the U.S. daily)

First, you've obviously read more details about this case than I have. That said, if Spencer is the only case and hasn't infected anyone else (despite what you consider poor choices), that strengthens the case that this is hard, hard, hard to transmit.

Let's look at that 100 to 150 people in context. The three countries with epidemics are Liberia, Sierra Leone and Guinea. According to Wikipedia, Liberia's population is about 4.4M, Sierra Leone's is 6.2M, Guinea's is 10.5M. Total for the three is about 21M.

It's hard to get a good number of how many actual cases, but WHO put out a number of 8,900 last week. Let's assume that's way underestimated and triple it. So roughly 30,000 cases. In a population of 21M, that's roughly 1.5 per thousand. If the folks coming in were infected at that rate, we'd expected to have seen about 1.5 cases a week. So I think it's safe to assume that, in fact, the people coming in are lower-risk than the general population, and that screening on the outbound side is helping in some way. (And yeah, this is just a back-of-the-envelope calculation.)

For me, the bottom line is two-fold. First, the best way to protect the world is to provide the resources needed to stop the epidemic in Africa. Second, despite the mistakes in Dallas, evidence says that the West isn't at risk the way parts of Africa are.

Tamar