Power of Words.
Power of Words.
One of you (or more) pointed this out recently. Words go beyond mere momentary compression of air molecules when spoken, mere coalescing of ink when printed. Forget the poetry. There are dozens of professionals who if they don't know public presentation/speaking already, and they should since it's part of their jobs, need to get up to speed yesterday.
The controversy of what happened at Newark Airport and in NJ combined with the doctor in NYC becoming ill has led to more coverage of the quarantine debate. It includes the fact that a bunch of soldiers who were sent to West Africa are being quarantined at their base for 21 days. It's unclear that any of these people had any direct contact with patients. They may simply have been building infrastructure - hospitals and the like - which would make their risk of infection extremely low. Since it's the military, they can kind of do what they want, I suppose, "out of an abundance of caution", but the words being used, at least second hand through the media, are "asymptomatic".
Simple definitions of asymptomatic may read as not showing symptoms of illness or disease. So you could choose to take that as synonymous with healthy, but it isn't. It's synonymous with not sick, which isn't the same thing, as it turns out. Moreover, the public hears words like this and goes, "omg, sick people!" Not without reason.
Ever hear of Typhoid Mary? True story. P.S. It's a lot easier to catch typhoid than ebola. Anyway, woman is never ill, works as a cook, people get sick, some die. Keeps happening. When they try to stop her, she won't change jobs, and since she's never been actively ill, she won't believe doctors or officials or anyone. Eventually, for genuine public health safety reasons, they lock her up in a hospital. She spends the rest of her life there (it's a long time). She was asymptomatic.
In addition, if you look up more than the most cursory definition* of the word asymptomatic, you find that in fact, it means people you are watching because you expect they could become sick. Technically, if you are talking about the NYC doctor's girlfriend, or the family of Thomas Eric Duncan in Dallas you could argue that was accurate, because they had close personal contact and were highly likely to have been exposed to body fluids from the sick person.
Nonetheless, they were well and there was no reason to expect them to become ill, per se. They were definitely exposed, so there's a reason to take extra cautionary measures. Plus, if it's done correctly, if they become ill that should get them faster, better, appropriate care.
Once again, I am going to praise Jay Varma, MD, Deputy Commissioner for Disease Control at the New York City Health Department, (and whoever else may have been part of the decision making team) for making a deliberate, repeated, clear, trained in talking points effort to tell NYC (and the international media) that we are talking about "well" persons who are "not sick". He isn't saying they don't need to be monitored by public officials, he isn't saying they don't need to be quarantined at home. He is saying They Are Not Sick. Therefore, they pose No Active Health Risk to anyone.
Why is this important? Because people get scared. Look at the Twitter posts calling the nurse who was grabbed and locked up at Newark a bitch for objecting to how she was treated. It was completely incompetent, btw.
But I digress. Words, folks. Words matter. These people have had direct contact with ill persons or they have not. If you are going to quarantine them, call it what it is but be honest. You are quarantining well persons whom we as a society have determined need to be isolated because it is clear that the onset can be subtle before it is suddenly severe and we are deeply concerned about putting anyone at any risk.
As an epidemiologist might put it, we will sacrifice specificity in the name of sensitivity. Just know that that means that a bunch of people there is no manifest reason to worry about may be locked up for three weeks at their and the taxpayers' expense.
* A few definitions of asymptomatic:
1. Presenting no symptoms of disease.
2. Persons who carry a disease and are usually capable of transmitting the disease but, who do not exhibit symptoms of the disease are said to be asymptomatic
3. Without symptoms. For example, an asymptomatic infection is an infection with no symptoms.
4. A term used to describe an individual who does not currently show symptoms of the disease being discussed. Asymptomatic individuals may develop symptoms of the disease at a later point in time if and when the disease onsets.
One of you (or more) pointed this out recently. Words go beyond mere momentary compression of air molecules when spoken, mere coalescing of ink when printed. Forget the poetry. There are dozens of professionals who if they don't know public presentation/speaking already, and they should since it's part of their jobs, need to get up to speed yesterday.
The controversy of what happened at Newark Airport and in NJ combined with the doctor in NYC becoming ill has led to more coverage of the quarantine debate. It includes the fact that a bunch of soldiers who were sent to West Africa are being quarantined at their base for 21 days. It's unclear that any of these people had any direct contact with patients. They may simply have been building infrastructure - hospitals and the like - which would make their risk of infection extremely low. Since it's the military, they can kind of do what they want, I suppose, "out of an abundance of caution", but the words being used, at least second hand through the media, are "asymptomatic".
Simple definitions of asymptomatic may read as not showing symptoms of illness or disease. So you could choose to take that as synonymous with healthy, but it isn't. It's synonymous with not sick, which isn't the same thing, as it turns out. Moreover, the public hears words like this and goes, "omg, sick people!" Not without reason.
Ever hear of Typhoid Mary? True story. P.S. It's a lot easier to catch typhoid than ebola. Anyway, woman is never ill, works as a cook, people get sick, some die. Keeps happening. When they try to stop her, she won't change jobs, and since she's never been actively ill, she won't believe doctors or officials or anyone. Eventually, for genuine public health safety reasons, they lock her up in a hospital. She spends the rest of her life there (it's a long time). She was asymptomatic.
In addition, if you look up more than the most cursory definition* of the word asymptomatic, you find that in fact, it means people you are watching because you expect they could become sick. Technically, if you are talking about the NYC doctor's girlfriend, or the family of Thomas Eric Duncan in Dallas you could argue that was accurate, because they had close personal contact and were highly likely to have been exposed to body fluids from the sick person.
Nonetheless, they were well and there was no reason to expect them to become ill, per se. They were definitely exposed, so there's a reason to take extra cautionary measures. Plus, if it's done correctly, if they become ill that should get them faster, better, appropriate care.
Once again, I am going to praise Jay Varma, MD, Deputy Commissioner for Disease Control at the New York City Health Department, (and whoever else may have been part of the decision making team) for making a deliberate, repeated, clear, trained in talking points effort to tell NYC (and the international media) that we are talking about "well" persons who are "not sick". He isn't saying they don't need to be monitored by public officials, he isn't saying they don't need to be quarantined at home. He is saying They Are Not Sick. Therefore, they pose No Active Health Risk to anyone.
Why is this important? Because people get scared. Look at the Twitter posts calling the nurse who was grabbed and locked up at Newark a bitch for objecting to how she was treated. It was completely incompetent, btw.
But I digress. Words, folks. Words matter. These people have had direct contact with ill persons or they have not. If you are going to quarantine them, call it what it is but be honest. You are quarantining well persons whom we as a society have determined need to be isolated because it is clear that the onset can be subtle before it is suddenly severe and we are deeply concerned about putting anyone at any risk.
As an epidemiologist might put it, we will sacrifice specificity in the name of sensitivity. Just know that that means that a bunch of people there is no manifest reason to worry about may be locked up for three weeks at their and the taxpayers' expense.
* A few definitions of asymptomatic:
1. Presenting no symptoms of disease.
2. Persons who carry a disease and are usually capable of transmitting the disease but, who do not exhibit symptoms of the disease are said to be asymptomatic
3. Without symptoms. For example, an asymptomatic infection is an infection with no symptoms.
4. A term used to describe an individual who does not currently show symptoms of the disease being discussed. Asymptomatic individuals may develop symptoms of the disease at a later point in time if and when the disease onsets.
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