Friday, November 07, 2014

An Abundance of Caution

**UPDATE//4:05 pm** Medical officials in Charleston now say the C-17 pilot is at "no risk" of having Ebola, based on his lack of contact with "anyone in Liberia."  The Air Force officer has been removed from isolation, though he apparently remains hospitalized with flu-like symptoms.

A point worth repeating: since the beginning of the U.S. military mission to Ebola-ravaged areas of West Africa, we've been told that service members face a very low risk of infection.  Their mission is focused on a variety of support functions, including security, logistics, and the establishment of new treatment centers.  Military personnel are not supposed to come in contact with actual Ebola patients, a line echoed by various officials at the White House and the Pentagon.

And events on the ground seemed to support that claim.  A number of troops (mostly Army and Air Force) have already returned from Liberia, and so far, none have been diagnosed with Ebola.  However, it is worth noting that DoD has mandated a 21-day monitoring period for all personnel returning from West Africa, based on the now-familiar "abundance of caution."

But others--including this blog--have argued that the Ebola mission subjects our service members to unnecessary dangers, given the limited training that most received before deployment--and the inevitability that a solider, sailor, airman or Marine will eventually come in contact with an infected individual, and contract the deadly disease.

That's why today's news out of Charleston, SC, is disturbing.  From WCSC-TV:

A pilot with the 437th Airlift Wing who flew a mission to West Africa on Oct. 23 and began experiencing "flu-like symptoms" this week is being screened for Ebola at the Medical University of South Carolina, according to Joint Base Charleston.

The serviceman, who lives off-base, began experiencing the symptoms on Wednesday, according to Staff Sgt. Anthony Hyatt.

While health officials believe he is an extremely low risk for Ebola, Joint Base Charleston coordinated with the state's Department of Health and Environmental Control to exercise "the appropriate protocols and an abundance of caution," Hyatt said.

The patient recently returned from a three hour stay in Liberia during which time he did not leave the plane, according to Mark Plowden, Communications Director for DHEC. The hospital activated their Ebola protocols after it was contacted Thursday night by DHEC regarding a patient requiring Ebola medical screening.

Other crew members who have traveled in the region are monitored for 21 days, and so far, only the pilot in question has shown any adverse symptoms," Hyatt said.

"The risk of Ebola is extremely low," said Plowden in a statement. "However, MUSC is following protective protocol as a precautionary measure."

At this point, it's quite likely the pilot is suffering from something other than Ebola.  But, given his symptoms (and recent stop-over in Liberia), activation of the protection protocols was required.  

And what if it is Ebola? (God forbid).  That might prompt a re-examination of how the mission is being conducted and supported. 

For starters, the pilot's potential exposure should have been minimal.  Information provided by the Air Force indicates that the pilot never left the flight deck during his three hour-stopover in Liberia on 23 October.  The engines of the C-17 remained running while the aircraft was on the ground and the crew had no contact with Ebola patients.  American personnel who serviced the aircraft and unloaded its cargo self-monitor for Ebola symptoms twice daily, and the airfield where the C-17 transited is under the control of the U.S. military.  

An Air Force spokesman also confirmed that the crew did not consume any food from Liberia while the plane was on the ground, saying there "many layers of separation" to protect the pilot and his fellow crew members.  

Still, we don't know all the details of the C-17 deployment.  Airlift crews typically deploy for more than a week at a time, with multiple sorties along the way.  After leaving Liberia, it's quite likely the C-17 stopped at bases in Europe before flying back to the U.S.  In fact, we don't know how much time elapsed between that stopover in Liberia and the C-17's return to Charleston.  Obviously, a longer gap would mean the pilot was exposed to more people in multiple locations, which could create massive public health headaches--if the pilot was somehow exposed to Ebola. 

There's also the matter of the aircraft.  Most likely, the Globemaster III departed again within a day or two of its landing at Charleston--in the hands of another crew.  So far, the Air Force hasn't disclosed where the jet has been since the air crew returned to the U.S.--or what steps would be taken if a crew member was subsequently diagnosed with Ebola.       



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