Talk:Ebola virus cases in the United States

Suggested article changes

Structure

I'd like to make some structural changes to the article, similar to ones made before. There are two ways to make these: 1) Discuss each one first, explaining why the original edit (with a diff) is an apparent problem with should be changed; or 2) Just make the change with the rationale explained in the summary. Your choice, SW3. I've already noted a few of these, but will copy and paste them again if you prefer. --Light show (talk) 20:43, 23 October 2014 (UTC)

What changes are you referring to? SW3 5DL (talk) 21:31, 23 October 2014 (UTC)

First mentioned here, and in the section following it. If you need them explained beforehand, I'll create a separate talk section. --Light show (talk) 21:40, 23 October 2014 (UTC)

But what specifically are you talking about? Are you referring to edits I've made now, or in the past? SW3 5DL (talk) 21:50, 23 October 2014 (UTC)

Mainly the ones from 10/18. You've only made a few since then. -Light show (talk) 22:08, 23 October 2014 (UTC)

I feel like we're playing charades here. Today is the 23rd. Could you please show diffs and also mention what exactly are you referring to? And referring to a large thread doesn't help. What specifically are you concerned about? Thanks. SW3 5DL (talk) 22:11, 23 October 2014 (UTC)

You made over 40 major edits over a few hours back then, some of which could use improvement. So I above suggested two ways to make them, but if you have any other ways, please suggest them. --Light show (talk) 22:23, 23 October 2014 (UTC)

And you came to my talk page and opened a thread here and that discussion, along with your subsequent reverts of my edits, seemed to have settled the matter. SW3 5DL (talk) 22:37, 23 October 2014 (UTC)

I only made a two edits since yours, one updating the infobox and the other suggested by you on my talk page. --Light show (talk) 22:49, 23 October 2014 (UTC)

As so much time has past, and other editors have made many changes, and you've not provided any diffs, then perhaps you could raise the issue of content in a new section and ask other editors what they think should and should not be included in the article. And I'd offer diffs of specifics so as to get the best feedback. And can you answer my question about the image below? Thanks. SW3 5DL (talk) 22:54, 23 October 2014 (UTC)

What or who were you referring to above by saying there were "subsequent reverts" of your edits, which apparently "settled the matter"? It seems that no one has reverted any of those 40, 10/18 edits. --Light show (talk) 23:34, 23 October 2014 (UTC)

I made section headings and subsection headings among other edits. They're all gone now. If there are other edits you have issues with, you need to open a new section and show diffs of content that you take issue with, so that other editors can comment. I'm just one editor here. SW3 5DL (talk) 23:50, 23 October 2014 (UTC)

You said above that the new section headings you added are "all gone now." Only a few changes made to your numerous section additions, were only by other editors removing the sub-sections you created for each of the five evacuated cases, with the text kept. Another two subsections you added were removed, but text kept, were "Rejection of student admissions" and "Speaking invitations withdrawn," both of which were brief news items. On the other hand, you added a dozen new sections, many like "Effects on hospital", supported by little more than news clip items. --Light show (talk) 00:40, 24 October 2014 (UTC)

Your links are to the state of the article on October 18th, five days ago. This is the state of the article as of right now, today, October 23rd. What are your issues with the state of the article right now? SW3 5DL (talk) 01:06, 24 October 2014 (UTC)

The links were only in reply to your comment, "I made section headings and subsection headings among other edits. They're all gone now." However, most are still there. --Light show (talk) 01:11, 24 October 2014 (UTC)

XD, I didn't add "Rejection of student admissions" and "Speaking invitations withdrawn." Those were made by another editor. I cleaned them up as best I could, but they were not my additions. A lot of that content that you seem to be referring to, as I can't be sure since you never provided diffs, doesn't sound like mine. I sorted material and made some subsections to break up walls of text, but I didn't add a lot of that stuff. I added the visa ban bits, and I deleted some section titles like the"controversies' section title. That sounded a bit melodramatic and undue. If you'd made proper diffs, like I asked, you might have figured it out. SW3 5DL (talk) 05:56, 24 October 2014 (UTC)

Specific suggestions

Feel free to either support or oppose suggestions directly beneath each one, and add other new bulleted ones.

• Move Cases in U.S. health care workers returning from West Africa to beginning of article, before the Duncan case, for accurate chronology. Also suggest renaming to briefer, Medical evacuations from West Africa, as the 1st sentence in the section can explain what they were.

• Comment: Reducing the article to a chronology that duplicates the List of Ebola virus disease cases article doesn't make sense. Dr. Brantly, Mrs. Writebol, et al, have recovered. They're old news. Even if new cases are evacuated, they don't represent the virus being diagnosed in America. Duncan, the two nurses who got it from him, and Dr. Spencer are the only ones diagnosed in America. Those are the cases readers will care about. In fact, the evacuated cases section could be moved off the article, as another editor earlier suggested. It could move off to the List of cases article and leave a sentence or two with a link. SW3 5DL (talk) 05:56, 24 October 2014 (UTC)

• Remove section International travel ban for monitored residents of Ohio and add the section's single sentence to another section with context.

• Comment: I think the travel ban for Ohio could be eliminated. SW3 5DL (talk) 05:56, 24 October 2014 (UTC)

• Demote sections, Airport screening and Call for suspension of visas to subsections under a new section covering all travel aspects.

• Comment: The visa bit can go, imo, since that's not taken effect. It seems its been dropped, at least for now. I imagine the issue of visa bans would make a comeback if the virus breaks out in other areas directly related to travelers. But otherwise, it's a non-starter here. The airport screening is an effort at containment and belongs in that section. SW3 5DL (talk) 05:56, 24 October 2014 (UTC)

• Remove section Operation United Assistance and add text somewhere related to the subject, as it's not about Containment efforts as most would understand the term. --Light show (talk) 02:54, 24 October 2014 (UTC)

• Comment: Obama specifically said it was an effort to contain the virus to prevent it's spread here. He said if we want to contain the virus here, we must contain the virus there. He also said airport screenings were efforts at containment. Sending troops to set up hospitals is a containment effort. I don't think it's reasonable to say otherwise. Everything the government does directed at preventing the spread of the virus is a containment effort. That includes cleaning apartments, contact tracing, imposing quarantines, airport screenings, sending troops to West Africa, educating the public, these are all efforts at containment. SW3 5DL (talk) 05:56, 24 October 2014 (UTC)

The term "containment" with regard to Ebola, or other past epidemics, seems to have a different and more specific definition than those. I checked sources by WHO, the CDC, the NIH, and even Obama, and they all use the term "containment" for either specific cases or very localized, containable outbreaks, which include steps like monitoring, quarantine and isolation. However, the extra-broad coverage that's now included in the Containment efforts section is closer to the definition of "containment" in the political sense, i.e. nuclear containment or George Kennan's ideas. If you want me to list the medical definitions of "containment" related to Ebola by all those other organizations, just say so. But the way it reads now, the section in the article includes seven subsections, but only CDC guideline revision would support the actual definition. The issue is kind of important to clear up since the subject of "containment" regarding Ebola should have its own section, and within that section would go the now separate major section, Biocontainment units in the U.S. --Light show (talk) 19:36, 24 October 2014 (UTC)

Light show, We need to reduce those subsections. One of the reasons I put in subsections was to also highlight material. So when some of the subsection titles got eliminated but not some of the material that went with them. . .my efforts were for naught, you know? I believe we discussed some of the material in those subsections earlier. Remember? The 'Containment efforts' section should include the Operation Assistance, the screenings, the things that Obama is doing. I know he's being criticized but I listened to his radio address on Saturday and he was on one of the Sunday morning shows, I think it was Meet the Press. I watched that. It would be helfpul if you would list here what you want in the section. The biocontainment units, etc. and we'll sort that. I think more space for containment and moderate space for the cases. Dr. Spencer needs his own section, and now the nurses can have less space, they've done well, one has been discharged from hospital the other is about to be, etc. What do you think? SW3 5DL (talk) 01:28, 25 October 2014 (UTC)

I think that if you or anyone sees a problem with any edits I make, we can discuss them. Mass deletions by any single editor aren't useful for collaboration, as there have been nearly 50 different editors working on this article just over the last few days. --Light show (talk) 02:31, 25 October 2014 (UTC)

Light show, I think your constantly referring back to that thread is counterproductive. One minute you seem to want to collaborate, the next you seem more interested in beating me with a a stick because I made a comment/revert for which I apologized and was reverted, and for which I was lead to believe had been resolved. Either you want to move past what seems to be your hurt feelings or you'll continue to engage in a negative way. It's your choice. But I'll not answer your comments again. SW3 5DL (talk) 03:21, 25 October 2014 (UTC)

I apologize for linking to that, but it's the only section about my edits to the article. I felt that by noting problems first and getting some agreement, that an effort to collaborate was implied. How many editors state their intentions to make improvements before making them? Not many. --Light show (talk) 03:43, 25 October 2014 (UTC)

But your issue was resolved there and on my talk page not long after, as you're well aware. And you only link to that first discussion as if all the subsequent resolution did not occur. You appear to refuse to let it go. Suggest you See "making an issue where none exists just so you can draw attention to the fact that you're still pissed off that SW3 reverted your edit even though SW3's revert got reverted by another editor about a minute later." SW3 5DL (talk) 16:17, 25 October 2014 (UTC)

more suggestions

• Remove the major section, Biocontainment units in the U.S. and put its text within a relevant section. The two-sentence section is basically a fact, but lacks any context.

Per above, the section has been moved to be a subsection of the Containment efforts section. --Light show (talk) 05:40, 27 October 2014 (UTC)

• Remove the major section, Public reactions, which consists of four isolated and unrelated news facts, most beginning "On October XX," but does not give any summary or general explanation about the public's reaction. The text should be moved to existing relevant sections.

• Comment: What are the relevant sections? SW3 5DL (talk) 18:11, 25 October 2014 (UTC)

• Revise the section, Containment efforts, and its subsections for more accurate context. Most sources refer to "containment" as isolating infected people, tracing their contacts to isolate them via quarantine, and only when a vaccine is available to vaccinate those at risk. It could include, for example, articles such as this one, about a new containment facility.

• Comment: That doesn't seem accurate to limit containment to those few measures. Actually, containment refers to efforts to stop the spread of a pathogen. That includes any measures that restrict contact with individuals who are infected. Those measures include closing borders, quarantining individuals, even whole neighorhoods or other living areas, rapid burial of the dead, restricting travel, screening at large travel centers such as airports, contact tracing, stopping the pathogen at its source, and if available, using pulse vaccination strategy to eliminate vulnerable hosts. With the exception of the vaccine, which is being fast-tracked by NIH, all the above actions, except closing the borders, are being taken by President Obama, the CDC, and the governors of Texas, New York and New Jersey. These efforts should all be included because that is actually what is being done to contain the virus in the United States. SW3 5DL (talk) 16:43, 25 October 2014 (UTC)

• Add a section for Preventive actions, or similar title, which would include travel screening, news about closing schools or businesses (even if unnecessary), etc. The current subsection, Operation United Assistance about the U.S. military helping in W. Africa should fit somewhere relevant.--Light show (talk) 03:13, 25 October 2014 (UTC)

• Comment: Preventive measures include educating the public about how a pathogen is spread and behaviours to engage in, (good handwashing) and behaviours to avoid, (contact with the blood and body fluids of others). In general, preventive measures head off problems before they occur and would also include developing vaccines. So the NIH work on the vaccine could be included in a Prevention section. But once a pathogen is among the population, efforts such as Operation United Assistance are all actions to actually stop the spread of the active pathogen. SW3 5DL (talk) 17:11, 25 October 2014 (UTC)

Prose

While we realize that events will change, the article is about a month old and some of the prose is excessively newsreel-sounding, IMO. For instance, there are 29 sentences that begin, "On October XX," followed by a news blurb of a sentence or two, ie. School closures. I think that rephrasing such sections and removing the police-report/news-diary sound, would improve readability and keep material in context. As it is, there are many strings of sentences that are dated factoids. Any agreement? --Light show (talk) 02:16, 24 October 2014 (UTC)

Light show yes absolutely. This is a common flaw with articles that get started based on unfolding news. Over time it gets cleaned up, but you're right the prose style really needs a lot of work in the direction you're pointing out. The whole article needs to be rewritten as topics instead of this case, that case, the other case. Zad68 05:54, 24 October 2014 (UTC)

I don't think we can prevent that type of 'prose' at this stage. It might be a time sink, but I like the idea of topics. Do you have an example of what you mean? SW3 5DL (talk) 01:30, 25 October 2014 (UTC)

Just compare Ebola response coordinator, which consists of prose, with the section following it, which reads like a bulleted-list of dated facts. --Light show (talk) 03:23, 25 October 2014 (UTC)

Normal lab values?

Regarding Duncan's first trip to the ED, why did we write "Lab results including white blood cell, platelets, glucose, creatinine, and aspartate transaminase (AST) all returned within normal ranges."? According to the congressional testimony, he had a number of abnormal labs: From my reading of the document, he was neutropenic (3.08), thrombocytopenic (92), had elevated LFTs (AST 94), and had evidence of mild kidney injury (Cr 1.41).
Am I missing something? I'll go ahead and correct this unless someone points out that I'm reading the source wrong.Onefireuser (talk) 02:50, 27 October 2014 (UTC)

The correction has been made. --Onefireuser (talk) 16:47, 27 October 2014 (UTC)

Whoa. Wait a minute. We should be careful not to SYNTH and OR conditions here. You may be a doctor, but we need some verifiable secondary source that cites these conditions from the lab results. Here's what the document says:

• WBC – 3.08 L (low end of ‘normal range’ 3.98)
• Platelets – 92 L (low end of ‘normal range’ 130)
• Glucose – 180 H (high end of ‘normal range’ 100)
• Creatinine – 1.41 H (High end of ‘normal range’ 1.25)
• AST – 94 H (‘normal’ <34); can reflect abnormalities in liver function or muscle tissue

Radiology results reviewed at 0128 and included:

• CT scans Abdomen & Pelvis- “no acute disease” and Head - “unremarkable”

Now I made the mistake of reading AST as "normal". That's a good catch. But the document notes everything else as being within the "normal range". I'm going to keep the 'low' and 'high' judgments (as they're noted in the document, but I have to remove the note about 'abnormalities ... some minor' as being OR not directly found in the citation. -- Veggies (talk) 19:30, 28 October 2014 (UTC)

I agree. Thank you for making the wording more neutral. Onefireuser (talk) 23:26, 28 October 2014 (UTC)

The New York Times: Wikipedia Emerges as Trusted Internet Source for Ebola Information

• Cohen, Noam (October 26, 2014). "Wikipedia Emerges as Trusted Internet Source for Ebola Information". The New York Times. Retrieved October 28, 2014.

Might be a useful source for use in this article. — Cirt (talk) 03:08, 28 October 2014 (UTC)

Numbers in infobox

The current set of numbers is a good start.

• Cases contracted in the U.S.
• Deaths
• Cases first diagnosed in U.S.
• Cases evacuated to U.S. from other countries
• Quarantined people
• People under observation
• Cleared after 21 days

I'd like to see some additions and clarifications.

• Total cases

which would be equal to cases first diagnosed in the US + Cases contracted in the US

Then,

• Cases cured
• Deaths (already present)
• Active cases

Which also adds up to the total.

See any problems with this? Suggestions for improvement? Thundermaker (talk) 07:37, 28 October 2014 (UTC)

Dr. Spencer's apparent lack of full disclosure

http://nypost.com/2014/10/29/ebola-doctor-lied-about-his-nyc-travels-police/. SW3 5DL (talk) 12:56, 29 October 2014 (UTC)

photo request

Can someone find a freeby photo of Amber Vinson? Thanks. SW3 5DL (talk) 13:42, 29 October 2014 (UTC)

A freebie picture of Amber will be harder to find. She didn't visit Obama like Nina Pham did (hence the freebie White House photo). Anyone know Amber? (lol) BlueAg09 (Talk) 14:02, 29 October 2014 (UTC)

Ah, that's the reason. I looked earlier this morning and couldn't find anything. I wondered why. Thanks. SW3 5DL (talk) 15:46, 29 October 2014 (UTC)

Page move

Ebola virus disease in the United States → Ebola virus cases in the United States – Discussion here shows continuing issues SW3 5DL (talk) 16:06, 29 October 2014 (UTC)

• Support - Use of the word 'disease' is not neutral or accurate. There is no Ebola disease in the United States. There are only isolated cases. The title Ebola virus cases in the United States was previously the most stable version and it had consensus. SW3 5DL (talk) 16:06, 29 October 2014 (UTC)

• Support: Agree with rationale. --Light show (talk) 16:43, 29 October 2014 (UTC)

• Support sure, with how the article content has been developing. It's not what I thought the article was supposed to be but I guess a more general article can be done elsewhere. Zad68 16:47, 29 October 2014 (UTC)
• Counter-proposal: Ebola in the United States. Clear. Unambiguous. Concise. Precise. --Born2cycle ☎ 16:58, 29 October 2014 (UTC)
  • The entire intro is wrong if you do not treat the hatnote as part of the intro, there have been cases of Ebola (Ebola Reston, or Reston Virus) previously in the United States, and zoological cases of Ebola Virus Disease in the United States in the 20th century. If we do not add "2014" to the article name, then the article should be expanded to cover the zoological cases as well. -- 67.70.35.44 (talk) 05:47, 30 October 2014 (UTC)
• Support "cases" is much more accurate and precise than "disease." The word "disease" also implies that we might be discussing previous research that 's taken place in the US. "Cases" makes it clear that we're just talking about this current Ebola scare. Onefireuser (talk) 17:55, 29 October 2014 (UTC)
• Support as above. Much more accurate and precise than 'disease.' Dr. Mike (talk) 19:48, 29 October 2014 (UTC)

discussion

@Born2cycle and В²C:, that's too vague and would only compound the problem, but thanks for the suggestion. I believe it was suggested way back when the article was created. Ebola virus cases in the United States is accurate and neutral. SW3 5DL (talk) 17:22, 29 October 2014 (UTC)

Vague? What else could "Ebola in the United States" reasonably mean other than "Ebola virus cases in the United States"? --В²C ☎ 17:35, 29 October 2014 (UTC)

Use of the term "cases" makes the title more precise, since Ebola alone is defined as a disease, but up until a month ago was only a disease in Africa. Adding the word "cases" implies that it is not endemic or a recognized disease in the U.S., since it is restricted to a few isolated cases, which makes it more precise and accurate. --Light show (talk) 17:47, 29 October 2014 (UTC)

Append: However, the word "virus" may not be needed, since Ebola is a virus. --Light show (talk) 18:16, 29 October 2014 (UTC)

Again, what else could "Ebola in the United States" reasonably refer to other than cases of the Ebola virus disease in the United States? To claim a need for precision, you must identify what else you believe the allegedly imprecise title may reasonably mean. --В²C ☎ 19:01, 29 October 2014 (UTC)

Wait, you think since "Ebola in the United States" could refer to an Ebola endemic in the US, or it being a "recognized disease" in the US, it's a problem? That's the epitome of unnecessary precision. Since we don't have articles about those more precise topics, there is no need to make this one precise enough to distinguish from them. --В²C ☎ 19:06, 29 October 2014 (UTC)

Hold on, didn't you mean to say "infer" instead of "refer," which have totally different meanings? What I wrote meant "infer." As for articles about those precise topics, this article is mostly about those very topics, primarily devoted to cases. To infer that some isolated cases warrants it being a "U.S. disease" might be the epitome of an unnecessary generality. The CDC rightly calls TB a "disease", while describing "cases" of Ebola in the U.S. --Light show (talk) 19:43, 29 October 2014 (UTC)

If we had to make our titles so precise that they could not infer anything else if taken out of context, well, we'd be doing nothing but renaming all of our titles. You're basing your argument on a requirement for WP article titles that does not exist. --В²C ☎ 20:21, 29 October 2014 (UTC)

Is Ebola in the U.S. different from Ebola anywhere else? No. An article with that title would seem too general, implying it's about the disease. But the article is about specific instances, namely some "cases" in the U.S. Per guidelines: Titles should be precise enough to unambiguously define the topical scope of the article,. --Light show (talk) 20:46, 29 October 2014 (UTC)

No, an article entitled Ebola would be a general article about the disease. An article with the title Ebola in the United States would be about the disease in the United States. If there are only handful of cases, then it's about that. If there are more than it's accordingly more general. But the title is appropriate either way. The title of the article should not depend on how many cases there are. Should we have a table set up that specifies the title based on how many Ebola cases there are? That's just silly. --В²C ☎ 21:42, 29 October 2014 (UTC)

Clunky lead

The current lead sentence is verging on unreadable:

There have been four cases of Ebola virus disease (EVD) diagnosed in the United States to date. Although first described in Africa in 1976[5], EVD was never seen in America until 2014.[6]

I suggest:

There have been four Ebola cases diagnosed in the United States to date. Although first described in Africa in 1976[5], Ebola was never seen in America until 2014.[6]

--В²C ☎ 17:39, 29 October 2014 (UTC)

Agree. Although most of the lead, which should be a summary of the article, now seems dated and off-balance, as it could include more of the recent details from the body text. For instance, the last sentence is too limited: Public health experts and the Obama administration have opposed instituting a travel ban on Ebola endemic areas, stating that it would be ineffective and would paradoxically worsen the situation. The lead doesn't mention airport screening, quarantines, CDC, or evacuated cases. To make room, the paragraph about Duncan, for one, could be summarized. --Light show (talk) 18:11, 29 October 2014 (UTC)

State by State?

Has any thought been given to splitting the article up based on State, maybe structured like the main 'Ebola outbreak in West Africa' article? 72.224.172.14 (talk) 13:46, 30 October 2014 (UTC)