Thursday, August 21, 2014

Ebola?

Media reports on the death of a Liberian traveler in Lagos, Nigeria, and the transfer of two American medical caregivers to the US for treatment due to the Ebola virus have definitely caught the world’s attention–and for very good reason.  We live in an interconnected world, and now have to accept the fact that rapid long distance air travel has the potential to spread nearly any infectious disease, viral or bacterial, to any other country, and ultimately the entire world.  Under this scenario, one person, unknowingly infected with some really nasty disease, could embark on an international flight and expose everyone aboard with the disease.  As those people disperse, traveling to whatever destination, they would of course be exposing all their fellow passengers to that same disease.  And consider what happens at major air terminals worldwide, as those exposed travelers wander about, waiting for their interconnecting flight!  In very short order, we have a quite serious worldwide pandemic exploding on the scene!

In the case of the current Ebola threat with it’s very high (50 to 90%) fatality rate, it’s no wonder that so many people are quite concerned about these possibilities, and a potential threat to the United States.  However, according to officials at the CDC, the actual chance of it developing into a serious public health risk in the U.S. is quite small, in part due to the mechanism of it’s spread.  Ebola is not an aerosol, it’s only spread directly, human-to-human, by direct contact with body secretions such as saliva, sweat, blood, and feces.  It can be spread through a break in the skin or mucous membranes, or after touching your nose, mouth or eyes after having contact with the virus.   It is not transmitted by coughing or sneezing (droplet spread), as would be the case for someone with influenza or measles.  (If it were, half the population of West Africa would be dead by now.)  Poor and crowded living conditions in the afflicted area, along with improper sanitation, and rudimentary medical facilities seem to be a very important element in the spread of the Ebola virus. These of course, are not the conditions we generally find throughout most of the Western world, unlike parts of Africa.

However, before we congratulate ourselves on our good fortune, remember that Ebola remains a worldwide hazard because it is one of the most deadly viruses known to man, due in part to its ability to constantly undergo mutations.  Remember the seemingly endless stream of influenza strains we’re threatened with each year?  Influenza constantly mutates (because of it’s quite simple make-up), into some new threat, much as Ebola seems to be doing.  And much like so many other diseases, Ebola could readily be weaponized by large terrorist organizations or an unfriendly power.  Currently consisting of only 5 known strains, Ebola was first identified in 1976 in the Western Democratic Congo.  (Along the Ebola river for which it’s named.)  Four of these strains can be spread to humans, while the fifth resides only in primates. The fruit bat, considered a culinary delicacy in West Africa, is presently believed to be a natural reservoir and primary vector of the virus, pending further study.

Symptoms begin suddenly–often with an intense headache and fatigue, sore throat and chills–followed by vomiting, and diarrhea with onset of a hemorrhagic rash in the upper roof of the mouth and skin that appears to be blister-like.  While the virus incubates in from 2-21 days, its important to know that only those who are symptomatic–generally after 8-9 days–having fever along with diarrhea, vomiting and potentially a hemorrhagic rash can transmit the virus to others.  As a result, if someone on a plane with active symptoms–including vomiting and diarrhea –soils a restroom, another person, unaware of the threat, could theoretically touch a contaminated area, and thus acquire the virus.  That said, it’s important to know that the majority of those who have become infected with the Ebola virus have been healthcare workers in constant close contact with patients, as well as family members caring for sick family members. 

It’s also important to know that persons with Ebola may have symptoms that are nonspecific (headache, chills, and fever) making quick identification of the virus nearly impossible. It could be easily be mistaken for other illnesses including malaria, cholera or even typhoid fever. Only many days into the illness–after the onset of profuse vomiting and diarrhea–will a patient exhibit the telltale signs of Ebola with bleeding from the mouth and nose along with rectal bleeding concurrent with shock, liver and renal failure, followed by continued bleeding and cardiovascular collapse.

At this time, there is no vaccine or antiviral medication available to treat the disease. Only supportive care, with intravenous fluids, platelet and blood transfusions are available to patients.  While there have been some promising experimental treatments in animals, (monoclonal antibodies), there are no specific treatments that are currently available for humans.  With technical issues regarding the high mutability of the virus preventing researchers from being able to produce a vaccine or viable antiviral medication, other issues such as the danger of handling the live virus have prevented more intense and speedy efforts to actively pursue such research.

The FDA is also warning consumers to be aware of supplements and other products sold online that are fraudulently marketed to treat or prevent Ebola infection. We currently have no agent, drug, dietary supplement, or herbal supplement that are shown to prevent Ebola infection or shorten the course of the infection.  Nor has there been sufficient time to study the disease with an eye toward producing any effective cure or preventive.  Of course this hasn’t stopped some Internet retailers from claiming that their products can be used against Ebola.

So, unless you’ve recently been to West Africa, the only current Ebola threat to American citizens is the very small number of snake oil peddlers capitalizing on public fears. Consumers beware: If it seems too good to be true, it probably is.




Wednesday, August 6, 2014

"Lumpy"

Our third Warbird Weekend was yet another rousing success, thanks to the hard work of the event staff, the sponsors, and a lot of unsung volunteers.  As usual, I joined a number of aviation enthusiasts in wandering around the parking ramp taking pictures, talking to the pilots, and in general drooling over the aircraft on display.  Unfortunately I seem to have a problem with my camera, as nearly three quarters of my pictures are either badly light streaked or out of focus.  (I will have a new camera next year!)  On the other hand, I ran into an old friend out there, and had the time of my life!

“Lumpy” is an AT-28D “Nomad”, a pilot training plane from the 1950’s, and after retiring from US service were modified in the 1960’s to be an armed light attack aircraft for use in the counter insurgency role.  For those of you who might be a bit confused by the name “Nomad” rather than “Trojan”, the T-28 series aircraft (A, B, and C models) were named the “Trojan”, while the armed “D” model variant was named the “Nomad”.  But the –28D certainly fits the name, as it’s most definitely a wanderer!  These planes served with the French Air Force in Algeria, where, adding to the confusion, they were called the Fennec.  Many were sent to the Congo during that unpleasantness.  Some were sent to the Philippines, while many others served with the air forces of South Vietnam, Thailand, Laos, and Cambodia during the Vietnam War.  The US Air Force retained quite a few AT-28D’s as well, where they operated as the famed “Zorro” Air Commando truck busters along the Ho Chi Minh trail.  (“Steel Tiger” to you vets.)

“Lumpy” was assigned to the Royal Lao Air Force, which is where I got into the act.  As an Air Commando, my assignment was to “Project 404”, in support the RLAF T-28 operation as an instructor, advisor, and doing whatever else needed doing.  (You haven’t lived until you try to teach a highly technical subject when you don’t speak the student’s language!)  Anyway, “Lumpy” was among sixty some AT-28’s, while I was one of many Air Commandos in the midst of the so-called “secret war” in Laos.  To make a long story short, “Lumpy” and I both survived  the war.  I came home, and “Lumpy” soldiered on, finally being evacuated to Thailand by a Lao pilot during those horrifying final days.  From there she somehow made her way to Australia for a few years, and was finally brought home to a well-earned retirement.  Nowadays several of those Lao AT-28D’s still survive and are flying in various countries, taking their rightful place in the Warbird lineup.
 
She showed up in Grangeville for our Warbird Weekend, complete with simulated guns and bombs, and flown by her current owner, Roger Collins of Woodinville, WA, and yes, it did take a few minutes to get my feet back on the ground.  Ron Morrell of Renton WA. showed up with his T-28A, (the shiniest T-28 I’ve ever seen), which made our part of the flight line quite interesting to a lot of people.  I managed to spend most of the weekend pestering Roger, discussing the Nomad operations in Laos with him, answering questions for a good many by-standers, and in general making a nuisance of myself.  Roger is an old USAF F-4 Phantom II driver who now flies because he enjoys flying.  Thus he could readily understand my excitement,  and tolerating my somewhat excessive exuberance, let me play Crew Chief once again, and even took me for a half hour ride in the old girl.  That certainly made my day!

I’ve often seen the “Old Guys” at airshows, seemingly lost in time as they stand almost reverently touching a particular warbird.  Now, as I’m reaching my twilight years, I guess I’ve become one of them, and can now understand them a lot better.  Those old guys aren’t lost, they’re remembering the days so long ago and often far away, when they and their aircraft took part in some earth shaking events.  To those of us who flew and fought in them, those old planes aren’t just a collection of nuts, bolts, rivets and sheet metal… they are living creations, each with it’s own character and personality… and our companions through some often terrifying experiences.

I’ll see you next year old friend.



Sunday, June 8, 2014

VA Scandal

The ongoing, and apparently escalating, scandal within the Department of Veterans Affairs has definitely stirred up a lot of interest within the veteran’s community, and in the national political arena as well.  Since the reports of ongoing improprieties hit the headlines (remember that I’m a Vietnam veteran, partially disabled, who is pretty well dependent on the VA for my ongoing medical care), I have been following the issue with considerable interest.  Let me state for the record that I, like the majority of veterans (reportedly 82%), am pretty well satisfied with the quality of VA medical care, although I can’t say the same about the assorted bureaucratic hoops I have to jump through on a regular basis. 

The problem arose when it was reported that the Phoenix VA hospital was cooking the books when reporting the delay time between patients requesting an appointment and actually seeing a Doctor.  Where the VA reported a 21-day average (only slightly more than the national average of 18.5 days), Phoenix often had numerous unreported delays well in excess of 100 days, and in some cases deaths as a result of those delays.  There is some reason to believe the present scheduling problem may not be as severe nationwide as is generally believed, with the worst delays, according to the VA, occurring in the Northwest, the South, and the Southwest, to some extent driven by a shortage in medical staffing.  The VA presently reports that they have 1,900 medical staff positions unfilled, including several in Phoenix.  A VA internal report also found "numerous allegations" of "daily of mismanagement, inappropriate hiring decisions, sexual harassment, and bullying behavior by mid- and senior-level managers."  The Phoenix bureaucracy however, in an effort to make themselves look good, and improve their chances for employee bonuses and raises (VA bonuses can exceed $30,000), misreported the problem and left themselves wide open for the ongoing scandal.  The VA Inspector General called for a nationwide review to determine whether similar problems were occurring at other locations, with 42 VA medical centers across the country now under investigation for possible abuse of scheduling practices. 

In 1921 the US Congress created the Veterans Bureau to administer assistance to World War I veterans. It quickly turned into a hotbed of corruption, and was abolished nine years later, to be replaced in 1930 by the Veterans Administration.  Scandals have seemed to follow the VA around ever since.  In this case, when the news hit the streets, Mr. Obama promptly informed us that he was “mad as hell”, which, with his similar comments about all the other government scandals of late, I can only conclude that he’s simply “Mad”!

The VA problems are however many faceted.  Like most government jobs, it’s a Civil Service position, which is an open invitation to kick-back and relax, take extended coffee breaks, and collect a nice fat paycheck and assorted bonuses at taxpayer expense.  There used to be a saying that Civil Service and NASA’s rockets had a couple of things in common, in that neither could be made to work, and neither could be fired!  NASA seems to have improved their position however.

The raging congressional demands for the head of VA Sec. Eric Shinseki should be no surprise to anyone.  It’s an election year after all, and both political parties, smelling blood, need someone to point their fingers at and mask their own failures.  Sen. John McCain of Arizona, Sen. Mark Udall of Colorado, Sen. Al Franken of Minnesota, Sen. Jeanne Shaheen of New Hampshire, and Deputy National Security Adviser Tony Blinken, have all called for Shinseki’s resignation, with our usual media sensationalism providing with a cheering section.  

Congress claims to be “cutting the wastage and deadwood” while playing to the crowd by slashing the budgets of the military, the VA, NASA, and assorted other departments.  They happily ignore the rather dismal shape our national infrastructure is in, our illegal immigrant problem, leaky borders, and bankrupt cities.  They ignore mental health care, failing education, and our own poor and homeless, all the while sending billions of dollars to third world petty dictators in the name of “humanitarian aid” that winds up in Swiss banks.  It’s Congress that has under-funded the VA for decades, while not least it was Congress that dramatically increased the services the VA must provide and the patients it must treat, without an increase in either funding or caregivers.  And it is Congress that ignores the fact that thanks to the miracles of modern medicine we are today able to save the lives of wounded troops who would have died on the battlefield in past wars, wounded warriors that now require extensive medical care. 

Instead of providing oversight as they’re supposed to do, members of Congress often skipped the hearings that they scheduled or requested on veterans’ affairs.  In one particularly shameful episode, a ranking member of the Veterans Affairs Committee who never served in uniform, who missed his own committee hearings and never heard the testimony in question, attacked the Veterans of Foreign Wars because the organization supported Shinseki.  If Sen. Richard Burr of North Carolina expected the Veterans of Foreign Wars, Disabled American Veterans, and the Paralyzed Veterans of America to apologize for not carrying out his political wishes, he made a serious tactical error, as I hope the upcoming election will demonstrate. The political trap door was sprung, and down went a man who was two-thousand miles away from the crime scene.  Mr. Obama smiled as he made a good man disappear, all the while blaming someone else. 

The only participant who emerged with dignity from it all was the victim, Eric Shinseki.   A retired general and wounded vet himself (he lost half of his foot to a land mine in Vietnam), General Shinseki served in the Army for thirty-eight years, rising to Army Chief-of-Staff.  Apparently it spoiled him for work in civilian Washington D.C.  In the Army, an officer might try to put a good face on unpleasant facts, but at least he’ll tell you the truth.  Shinseki made the mistake of trusting civilian careerists chasing bonuses the way he’d trusted subordinates in the Army.  Still, Gen. Shinseki made real progress during his tenure. The backlog of claims was reduced by nearly half and patient care was greatly expanded.  But Shinseki could not fix an entrenched spoils system and a half-century’s damage in a mere five years.  Now, a man who has dedicated his entire adult life to serving our country, leaves office under a dark cloud whipped up by politicians, from Mr. Obama, to worried Democrats running for Congress who’ve suddenly discovered disabled veterans, to equally cynical Republicans exploiting veterans for a campaign advantage.  To me, our Congress critters make the Kardashians look like paragons of virtue! 


The mob won.  Our country, and our veterans, lost once again.  And Eric Shinseki, an American hero, was sacrificed on the alter of political expediency.