Tag: contact tracing

Bioethics Blogs

In the Journals – June 2017, part one by Aaron Seaman

Anthropology and Aging (open access)

The Social Context of Collective Physical Training among Chinese Elderly: An Anthropological Case Study in a Park in Beijing

Yeori Park

This study analyzes the social context in China where the elderly participate in collective physical training, a cultural activity specific to the country. For this study, senior citizens aged 60 or above who participated in collective physical training in a park in Beijing were observed for five months. Research results found that collective physical training enables formation of social networks providing mutual caring and support. On the other hand, the participants conform to the self-disciplined modern discourse to survive in the post-Mao society. They do collective physical training due to their social conditions, such as the poorly established welfare system for the aged, severance pay that is too low to cover medical expenses. Although the participants seem to autonomously choose collective physical training based on their own preferences, the context of Chinese society, including hidden government intentions, leads the elderly to participate in training activities.

Social Contract on Elderly Caregiving in Contemporary Chile

Carola Salazar

This paper explores the definitions of social contract on elderly caregiving among a group of seven Chilean aging experts. The data show that for Chileans, family remains a strong institution that should provide care of its members, with daughters or daughters-in-law being the preferred person to provide care. Also, age segregation, along with the gradual privatization of services such as health care and the pension system, promotes individuality: this can become a problem for future generations because they are no longer concerned with helping others.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Where Has SARS Gone? The Strange Case of the Disappearing Coronavirus by Robert Peckham

The emergence of Severe Acute Respiratory Syndrome (SARS) in China’s Guangdong Province in the winter of 2002 was an exemplary spillover event: it marked the passage of a lethal pathogen from nonhuman to human animals and was widely heralded as the first “plague” of the twenty-first century. The SARS coronavirus seemed to burst out of nowhere and demonstrated pandemic potential from February 2003 when it diffused globally via Hong Kong. After SARS was officially declared contained by the World Health Organization (WHO) on 5 July 2003, there were a few isolated cases but none since 2004.

SARS in the SAR

Hong Kong was at the epicenter of the 2003 SARS outbreak and the identity of the newly recognized pathogen became fortuitously linked to Hong Kong’s evolving status as a postcolonial Chinese city under Deng Xiaoping’s “One Country, Two Systems” policy. Since its “handover” from Britain in 1997, the territory had been a “Special Administrative Region” (or SAR) of the People’s Republic of China (PRC) – a quasi-autonomous region within the sovereignty of China.

In a WHO press release on 15 March 2003, the new “syndrome,” which had made its first appearance in Hong Kong in February of that year, was named “SARS.” The acronym was easily confused with the abbreviation SAR by which Hong Kong was known. SARS and SAR acquired a disturbing indexicality. Referred to sardonically by some commentators as the “Special Administrative Region Syndrome,” Hong Kong officials were wary of using the term SARS to describe the new disease. Instead, they continued calling it “atypical pneumonia.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Ebola Fever: “Don’t Panic”

by Craig Klugman, Ph.D.

In The Hitchhiker’s Guide to the Galaxy, author Douglas Adams provided his protagonist with two pieces of advise: don’t panic and always carry a towel. The first is good advice when it comes to Ebola panic.

I was sitting down on the plane in San Diego airport after the American Society for Bioethics & Humanities meeting when I noticed a woman walking down the aisle with a face mask. Being a public health-oriented person, I figured she had tuberculosis and was under order to wear a mask to protect other people’s health. But then a man came aboard with a mask and soon thereafter there was an entire family. I thought there couldn’t be that many people boarding this flight with infectious diseases and then it hit me—they weren’t protecting us, they were hoping to protect themselves from Ebola.

The rub, of course, is that Ebola is not airborne and thus, cannot be transmitted through the air. The masks would do nothing except maybe ward off a cold or flu. Perhaps that fact was known by one passenger at Dulles airport outside Washington DC who showed up for a flight wearing a homemade hazmat suit.

Given all that, I suppose I should not have been surprised when I received a call from my dentist today. Yesterday I had been there for a regular cleaning. Above every chair, this office has a television and as it was 5pm, the TV was set to the news. We began talking about an Ebola story and I mentioned that I had given several interviews with the media about Ebola lately.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Spanish Ebola case highlights risks to healthcare workers

A nurse who cared for an Ebola patient repatriated to a Madrid hospital has contracted the disease, the Spanish health ministry announced on 6 October. The news is unfortunately not surprising, however.

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US National Institute of Allergy and Infectious Disease

Although Ebola is relatively difficult to catch in the community because infection requires contact with the bodily fluids — such as blood or vomit — of an infected person, close contacts and health-care workers treating Ebola patients have long been recognised as groups most at risk of contracting the virus.

Health-care workers have already paid a heavy price in the current epidemic in west Africa: as of 1 October, the World Health Organization estimates that 382 have contracted Ebola, and 216 of them have died.

Spanish authorities will investigate how the nurse at the Carlos III hospital came to be infected, and whether there were any shortcomings in infection control — such as in the personal protective equipment supplied, training in its use, or in hospital hygiene. As someone who recently treated an Ebola patient, the nurse would have been considered a contact at risk of exposure to the virus, and have been monitored for any symptoms such as fever, that could signal the onset of Ebola. Such surveillance of contacts is critical to preventing any onward spread of virus.

It’s important to remember that people with Ebola don’t become infectious until they start showing symptoms, so monitoring of contacts of an Ebola-infected patient for fever is usually considered sufficient, with them being isolated only at the first hint of illness — although some authorities may choose to quarantine high-risk contacts.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Ebola in the US: Privacy, public interest and the ethics of media reporting

The first confirmed case of ebola has been found in the US, in Texas – unsurprisingly someone who had recently been to Africa. This has prompted an outbreak… of unethical media reporting about the case, with several breaches of privacy which seem unlikely to be in the public interest. Specifically the media has disclosed the victim’s full name, then to add insult to injury they published both his address and then a map of where he lives.

The media frenzy around this case is as unwarranted as it is unsurprising – scarily reminiscient of the painfully telling Onion piece – which claimed just 50 more white people needed to die of Ebola before a vaccine would be developed…

But even if we accept that the public is interested in the case (which no doubt they are) and that this interest warrants reporting on it does that give the media the right to release this person’s personal details and movements?

The main argument that can be offered for breaching typical standards of confidentiality is that the breach is in the public’s interest – this is the defense typically usually used in whistle blowing cases and in cases where medical professionals break confidentiality to prevent harm to others.

So isn’t this justification enough? Aren’t all Americans now at risk of ebola, amd hence have a right to know about who has it and where it is so they can choose to minimise their own risk?

It is worth noting that whilst Ebola is to be frank a terrifying disease it is relatively easily containable by the use of routine public health measures such as surveilance, isolation, contact tracing and modern hygiene standards and practices as it is spread through fairly obvious contact with bodily fluids, rather than airborne.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

A Primer on Ebola: Ethics, Public Health, and Panic

by Craig Klugman, Ph.D.

Ebola is in the news a lot with the diagnosis of the first case on U.S. soil (excluding the 4 cases of health workers who were repatriated from West Africa after falling ill with the disease). Lots of information is flying around the internet and the news media. The ethics of outbreaks is not a new topic and has been written about extensively in this blog as well as elsewhere. Experts in public health ethics have addressed this issue thoroughly.

Below are some thinking points about Ebola to help put the situation into perspective and to provide some points for reflection.

  1. It’s hard to get. Ebola is a virus transmitted through bodily fluids. You have to come into contact with the secretions or blood of an infected person and it enters your body through a cut or a mucous membrane. Ebola cannot be transmitted causally or through the air like influenza.
  2. Ebola can only be transmitted when a patient has symptoms.
  3. The infection rate in West Africa is high because (a) a shortage of trained health professions and medical supplies means caregivers lack adequate personal protection and can then act as disease vectors, (b) poorly funded public health systems means its hard to respond to the disease, (c) the funerary rites in many of these places include touching the deceased, washing the body, and even kissing the body.
  4. Ebola has been in the United States before. In 1989, 1990 and 1996 Ebola was found in monkeys imported into quarantine facilities. In the 1990 case, four humans were found to have antibodies but were not sick.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Ebola: An Emergency within an Emergency

Alison Thompson suggests that the Ebola outbreak is part of a larger emergency defined by a lack of public health infrastructure.

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Amid the worst Ebola outbreak ever, the World Health Organization (WHO) has declared that it can be ethical to offer experimental pharmaceutical interventions. Normally, experimental drugs and vaccines are first tested on healthy volunteers. But, in the case of Ebola, a public health crisis of international significance, this is a luxury we don’t have time for.

Two American aid workers who contracted Ebola were recently treated with an experimental drug called ZMapp. And following the WHO’s declaration regarding experimental Ebola drugs and vaccinations, Canada has pledged to donate up to 1000 doses of the experimental Ebola vaccine called VSV-EBOV. Neither ZMapp nor VSV-EBOV has been tested on humans.

"Kenema Hospital Sierra Leone Ebola" by Leasmhar

“Kenema Hospital Sierra Leone Ebola” by Leasmhar

The allocations of these scarce, potentially useful experimental drugs should be done in a way that restores trust. This is particularly true in the case of experimental vaccines because of the history of vaccine boycotts in West Africa stemming from deep mistrust of Western intervention. There is strong suspicion, especially in Northern Nigeria, that vaccines are the vehicle for the West to sterilize or infect Africans with the HIV virus. So, introducing an experimental vaccine in this region that could cause harm is a very risky proposition and it could have far-reaching consequences for the efforts to control polio and other infectious diseases. Whether or not the usual prescription for trust-building, such as being transparent, listening to communities about their concerns and being responsive to them will be enough to allow people to place their trust in outsiders again remains to be seen. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.