The Special Inspector General for Afghanistan Reconstruction just released the 25th quarterly report (pdf) on US reconstruction efforts in Afghanistan. We are of course at a major crossroads in US involvement in Afghanistan, as US and NATO combat involvement are being phased out and Afghanistan assumes responsibility for its own security. Some US and international troops will remain in Afghanistan after the end of this year under the new Bilateral Security Agreement, but with Afghanistan in charge it is of utmost importance that the Afghan National Security Forces (ANSF) are fully staffed and functional so that they can take on their responsibilities. One of SIGAR’s key roles in its oversight activity through the years has been to collect and review information coming directly from ISAF, the International Security Assistance Force, concerning the recruitment, training and subsequent capabilities of ANSF. ISAF ostensibly is a NATO team but is of course dominated, both in command and in personnel, by the US military.
Suddenly, in the final SIGAR report before the current ISAF mission ends and operations move to the new arrangement, ISAF, and more specifically ISAF Joint Command, has decided to classify the reports it prepares on ANSF troop capability. Here is Inspector General John Sopko in his cover letter accompanying the quarterly report:
This quarterly report also examines the reconstruction effort across the security, governance, and economic sectors. In the security sector, SIGAR was deeply troubled by the decision of the International Security Assistance Force (ISAF) to classify the executive summary of the report that assesses the capability of the ANSF. For years, SIGAR has used the ISAF report as a primary metric to show Congress and the public the effectiveness of the $61.5 billion U.S. investment to build, train, equip, and sustain those forces. Prior to this quarter, aggregate data on the operational effectiveness of the ANSF were unclassified in the Regional ANSF Status Report (RASR) as well as its predecessors, the Commanders’ Unit Assessment Tool (CUAT) and the Capability Milestone rating system.
ISAF’s classification of the report summary deprives the American people of an essential tool to measure the success or failure of the single most costly feature of the Afghanistan reconstruction effort. SIGAR and Congress can of course request classified briefings on this information, but its inexplicable classification now and its disappearance from public view does a disservice to the interest of informed national discussion. Moreover, while SIGAR understands that detailed, unit-level assessments could provide insurgents with potentially useful intelligence, there is no indication that the public release of aggregated data on ANSF capabilities has or could deliver any tactical benefit to Afghan insurgents.
It is very difficult to see this move by ISAF as anything more than a blatant attempt to cover up massive failure on the part of the efforts to train Afghan troops to take over their own security functions. This move by ISAF follows previous efforts that also come off as attempts to game the system so that evaluation of the always-claimed “progress” is difficult to impossible. Note in Sopko’s letter that he refers to three different systems by which troop readiness has been analyzed and reported. First, we had the Capability Milestone system, which was replaced by the Commanders’ Unit Assessment Tool (CUAT) and the now-classified Regional ANSF Status Report has replaced CUAT.
In March of 2013, I pointed out SIGAR’s frustration with how ISAF was gaming the CUAT:
A related area in which SIGAR has found a disgusting level of dishonesty is in how the US goes about evaluating Afghan forces in terms of readiness. Because it became clear to the trainers in 2010 that they had no hope of achieving the trained and independent force size numbers that NATO planners wanted (and because SIGAR found that the tool they were using at the time was useless), they decided that the only way to demonstrate sufficient progress was to redefine the criteria for evaluating progress. From the report:
In 2010, SIGAR audited the previous assessment tool—the Capability Milestone (CM) rating system which had been in use since 2005—and found that it did not provide reliable or consistent assessments of ANSF capabilities. During the course of that audit, DoD and NATO began using a new system, the CUAT [Commander’s Unit Assessment Tool], to rate the ANSF. In May 2010, the ISAF Joint Command (IJC) issued an order to implement the new system which would “provide users the specific rating criteria for each [ANSF] element to be reported by the CUAT including leader/commander considerations, operations conducted, intelligence gathering capability, logistics and sustainment, equipping, partnering, personnel readiness, maintenance, communications, unit training and individual education, as well as the partner unit or advisor team’s overall assessment.”
Since the implementation of the CUAT, the titles of the various rating levels have changed, as shown in Table 3.3. In July 2012, the Government Accountability Office (GAO) raised concerns that the change of the title of the highest rating level from “independent” to “independent with advisors” was, in part, responsible for an increase in the number of ANSF units rated at the highest level. GAO also noted that “the change lowered the standard for unit personnel and equipment levels from ‘not less than 85’ to ‘not less than 75’ percent of authorized levels.” In a response to SIGAR last quarter, the IJC disagreed with GAO’s assessment, saying a change in title does not “equal a change in definition.” Since last quarter, the IJC has initiated a CUAT Refinement Working Group to standardize inputs and outputs in the areas covered by the assessments.
But it turns out that the CUAT itself was developed only when SIGAR initiated an audit (pdf) of the Capability Milestone rating system. So, twice, when SIGAR decided to audit the system for evaluating Afghan troop readiness, ISAF responded by developing a totally new system, creating a strong discontinuity in the ability to track Afghan troop readiness over time. And now that we are at the most important moment for Afghan troops to be ready, ISAF decides that any information at all on their readiness is classified, even though they have provided the very same information without classification for years.
When we drill down to the details about the classification that SIGAR provides in the report, we see in footnote 196 (page 94) that they were informed of the classification in response to a data call submitted to IJC on October 3 of this year. Noting this and the arguments that SIGAR provides that aggregate data on Afghan troop readiness should not provide any sort of strategic advantage to insurgents, I submitted the following question to SIGAR: Continue reading
Yesterday evening, an Antares rocket built and operated by Orbital Sciences Corporation exploded shortly after liftoff. The rocket was intended to ferry supplies and equipment to the International Space Station. Orbital and Spacex have taken over some of the duties supplying the space station since the termination of NASA’s shuttle program.
In the early aftermath of the explosion, word came out that the crash site had to be secured because sensitive cryptographic equipment was on board:
The Cygnus mission was non-military, but the company’s Antares program manager, Mike Pinkston, said the craft included “some classified cryptographic equipment, so we do need to maintain the area around the debris in a secure manner”.
That initially struck me as odd. The International Space Station has a large number of cooperating countries, including Russia. It’s hard to imagine that the US would put sensitive equipment into the hands of cosmonauts right now, given the cool state of US-Russian relations. Of course, it would make sense for ISS communications to be encrypted in order to prevent meddling by hackers, but movement all the way to classified (and presumably military or NSA-level) encryption seems to be excessive.
This morning, we are seeing walk-back on the presence of classified equipment:
Shortly after the explosion, CNN quoted a launch director as saying that the spacecraft contained classified “crypto” equipment, but early Wednesday a NASA spokesman said by email that “We didn’t have any classified items on board.”
In trying to make sense of what could have been behind these strange statements, I ran across this interesting announcement of a new cryptographic technology that European scientists have proposed evaluating in an experiment on the space staion:
A team of European researchers have proposed a series of experiments that, if successful, could turn the International Space Station into a key relay for a quantum communications network.
The key basis of physics underlying quantum communications is entanglement. Entangled particles are connected in a way that pretty much defies common sense. If you change the spin of one of the particles, the spin of its entangled counterpart will change – even if they’re miles apart. And that change happens nearly instantaneously – at least four orders of magnitude faster than the speed of light, according to a recent experiment.
Another remarkable aspect of this technology that sounds almost too good to be true is its potential security. After noting that quantum networks are quite fragile, the Forbes article continues:
But why bother with these networks at all if they’re so fragile? The answer is pretty simple – because they’re almost perfectly secure. Here’s how it works. Let’s say that I want to send a message to New York City. My message is going to travel through normal channels, but it will be encrypted with a key. That key is transmitted via the entangled photons – so the changes I make to entangled particles on my end almost instantly show up in the particles in New York. We then compare the measurements of what I changed in my photons to those states in New York City.
Those measurements then comprise an encryption key for our communications. So even if our communications are bugged, nobody can read them without knowing that encryption key. And here’s the important thing: if somebody were to try to eavesdrop on the quantum entanglement, they would alter the spin of the photons. So the measurements I make and the measurements made in New York would be out of sync – thus letting us know that we have an eavesdropper. It also prevents us from creating an encryption key, so we don’t send any communications. Theoretically, a quantum encrypted network is almost perfectly secure. (That said, they’re not perfect, and there are some exploits.)
The announcement from the European group that they wished to carry out the experiment based on what Einstein called “spooky action over a distance” came last April. Then, in June, it was announced that China had carried out a key demonstration of concept experiment back in 2010 but waited four years to publish the result.
With China announcing progress on the technology, one would think that the West would want to accelerate its work in the area, so it would not be at all surprising if equipment for the European experiment was among the items lost when the rocket exploded. Further, one would expect that Orbital would have been told that security for that equipment would be of the very highest level. In discussing the issue of sensitive equipment among the Antares wreckage, PCWorld this morning mentioned the incident of China perhaps examining the wreckage of the US stealth helicopter that was left behind after the mission to kill Osama bin Laden. It could well be that for this crash site, keeping the debris away from prying eyes from China is behind the call for security. Note also that the experiment quite likely would have been coordinated by the European Space Agency on behalf of the European scientists, so NASA’s claim that “We didn’t have any classified items on board” could be parsed as not applying to any classified items that ESA might have had on the rocket.
It’s really difficult to say which poor response to Ebola has done more damage to the public health system in the United States. First, we had the series of unforgivable errors at Texas Health Presbyterian Dallas that resulted in Thomas Duncan being sent home with Tylenol and antibiotics when he first presented with Ebola symptoms. This was followed up after he was admitted by Nina Pham and Amber Vinson coming down with the disease after they treated him. Now, we have Kaci Hickox, who treated Ebola patients in West Africa, confined to an unheated tent in a New Jersey hospital for 21 days even though she is asymptomatic and has tested negative for Ebola. Twice.
The hysteria over retracing the steps of Craig Spencer in New York City just before he developed his fever illustrates the way the US press has misled the public about when and where Ebola risk exists. Abundant evidence from this and previous Ebola outbreaks demonstrates clearly that there simply is no risk of transmission from asymptomatic patients and that transmission risk grows through the course of the infection.
We see that principle demonstrated very clearly in Duncan’s case history. See this terrific ABC timeline for relevant dates quoted below. Duncan arrived in Dallas September 20. No passengers on any of the flights he took have developed Ebola. The incubation period has elapsed, so we know that no transmission of the virus occurred during any of his flights. Duncan had symptoms on his first hospital visit on September 26 but was sent home. He was later admitted on September 28. No patients or personnel from the hospital became infected from his visit September 26. The incubation period has expired, so we know for certain that transmission did not occur for anyone near Duncan that day. Similarly, even though they were in the apartment with him for days after he developed symptoms, none of the residents of or visitors to the apartment where Duncan was staying in Dallas became infected. The incubation period for that exposure also has expired. From this timeline developed by the New York Times, it appears that Pham and Vinson treated Duncan on the day before he died, which would be at the time when the amount of virus being produced by his body was nearing its maximum.
I had really hoped I wasn’t going to have to write this post. Yesterday, Marcy emailed me a link to a Washington’sBlog post that breathlessly asks us “Was Ebola Accidentally Released from a Bioweapons Lab In West Africa?” Sadly, that post relies on an interview with Francis Boyle, whom I admire greatly for his work as a legal scholar on bioweapons. My copy of his book is very well-thumbed. But Boyle and WashingtonsBlog are just wrong here, and it takes only seconds to prove them wrong.
Shortly after getting the email and reading the blog post, I sent out tweets to this summary and this original scientific report which describe work on DNA analysis of Ebola isolated from multiple patients during the current outbreak. That work conclusively shows that the virus in the current outbreak is intimately related to isolates from previous outbreaks with changes only on the order of the naturally occurring mutation rate known for the virus. Further, these random mutations are spread evenly throughout the short run of the virus’s genes and there are clearly no new bits spliced in by a laboratory. Since I wasn’t seeing a lot of traction from the Washington’sBlog post, I was going to let it just sit there.
I should have alerted last night when I heard my wife chuckling over the line “It is difficult to describe working with a horse infected with Ebola”, but I merely laughed along with her and didn’t ask where she read it.
This morning, while perusing the Washington Post, I saw that Joby Warrick has returned to his beat as the new Judy Miller. Along with the line about the Ebola-infected horse, Warrick’s return to beating the drums over bioweapons fear boasts a headline that could have been penned by WashingtonsBlog: “Ebola crisis rekindles concerns about secret research in Russian military labs“.
Warrick opens with a re-telling of a tragic accident in 1996 in a Soviet lab where a technician accidentally infected herself with Ebola. He uses that to fan flames around Soviet work in that era:
The fatal lab accident and a similar one in 2004 offer a rare glimpse into a 35-year history of Soviet and Russian interest in the Ebola virus. The research began amid intense secrecy with an ambitious effort to assess Ebola’s potential as a biological weapon, and it later included attempts to manipulate the virus’s genetic coding, U.S. officials and researchers say. Those efforts ultimately failed as Soviet scientists stumbled against natural barriers that make Ebola poorly suited for biowarfare.
The bioweapons program officially ended in 1991, but Ebola research continued in Defense Ministry laboratories, where it remains largely invisible despite years of appeals by U.S. officials to allow greater transparency. Now, at a time when the world is grappling with an unprecedented Ebola crisis, the wall of secrecy surrounding the labs looms still larger, arms-control experts say, feeding conspiracy theories and raising suspicions.
Enhancing the threat is the facilities’ collection of deadly germs, which presumably includes the strains Soviet scientists tried to manipulate to make them hardier, deadlier and more difficult to detect, said Smithson, now a senior fellow with the James Martin Center for Nonproliferation Studies, a research institute based in Monterey, Calif.
“We have ample accounts from defectors that these are not just strains from nature, but strains that have been deliberately enhanced,” she said.
Only when we get three paragraphs from the end of the article do we get the most important bit of information to be gleaned from the Soviet work on Ebola:
Ultimately, the effort to concoct a more dangerous form of Ebola appears to have failed. Mutated strains died quickly, and Soviet researchers eventually reached a conclusion shared by many U.S. biodefense experts today: Ebola is a poor candidate for either biological warfare or terrorism, compared with viruses such as smallpox, which is highly infectious, or the hardy, easily dispersible bacteria that causes anthrax.
Note also that, in order to make Ebola more scary, Warrick completely fails to mention the escape of weaponized anthrax from a Soviet facility in 1979, infecting 94 and killing 64, dwarfing the toll from the two Ebola accidents.
And lest we calm down about Ebola and the other bioweapons the Soviets worked on, Warrick leaves us this charming tidbit to end the article: Continue reading
In the historic city of Isfahan in Iran yesterday, several thousand protesters gathered in front of the judiciary building and shouted slogans against assailants who have thrown acid on a number of women in recent weeks. Even though a spokesman for the Iranian judiciary announced Monday that four attackers had been arrested and that the harshest possible punishment will be handed out, the protesters appeared to feel that not enough is being done.
The Guardian describes the situation that led to the protests:
Assailants riding on motorbikes, in a similar sequence of events, have thrown acid in the face of at least eight women who were driving in the street with their windows pulled down. Local media say the number of victims could be higher. The attacks have so far claimed one life, an opposition website said.
Many Iranians believe that victims were targeted because they were women wearing clothes that could be deemed inappropriate in the eyes of hardliners – a claim vehemently denied by the authorities.
Isfahani citizens, horrified by the scale of vicious assaults, gathered in front of the city’s justice department on Wednesday, calling on the authorities to put an end to the crimes which has highlighted the striking challenges women face in Iran, where hijab is obligatory.
A number of protesters in Isfahan chanted slogans that described the attackers as Iran’s own version of Isis, the extremist group that has committed many atrocities in Iraq and Syria.
Somehow, I suspect that these opposition groups will be very unhappy with Thomas Erdbrink’s coverage of the protest, though. Erdbrink notes that the protest appears to have been organized through social media, which may be a hint that he thinks the opposition groups helped to organize it. The opposition groups would go along with Erdbrink’s coverage of a proposed new law at the heart of the controversy:
The acid attacks have prompted a heightened resistance to the new law, which Parliament passed on Sunday. The law is aimed at protecting citizens who feel compelled to correct those who, in their view, do not adhere to Iran’s strict social laws. The details of the law, which would officially empower the government and private citizens to give verbal or written statements on social mores, have yet to be completed.
While strict rules on dress, alcohol, sexual relations and much more are not new, the law is aimed at defining crimes against propriety or decency, which in the past would often be corrected informally. In Iran, where most people live in cities and many are highly educated, conservatives are trying to avert changes in attitudes by enforcing traditions.
But Erdbrink points out that Hassan Rouhani spoke out very forcefully against the law, providing a stark contrast to the image the opposition paints of him going along with harsh punishment meted out by conservatives:
President Hassan Rouhani strongly criticized the new law on Wednesday, saying that he feared it would divide society because, as many observers have pointed out, in reality it offers the country’s small but influential faction of hard-liners more power.
“The sacred call to virtue is not the right of a select group of people, a handful taking the moral high ground and acting as guardians,” Mr. Rouhani said during a trip to the provincial city of Zanjan. “It is upon all Muslims to exhort love, respect for others and human dignity.”
“May such a day never come that some lead our society down the path to insecurity, sow discord and cause divisions, all under the flag of Islam,” he said, his voice shaking with emotion.
What a powerful statement. Imagine if Barack Obama said “May such a day never come that some lead our society down the path to insecurity, sow discord and cause divisions, all under the flag of Christianity”. And imagine if he said it with a voice shaking with emotion.
Sadly, both Iran and the United States have already reached that point where religious conservatives have caused insecurity, sown discord and caused divisions. And that is what makes Rouhani’s statement so dangerously courageous and prevents Obama from ever contemplating doing the same.
I’m either a lone voice in the wilderness or just another angry old man shouting at clouds on this, but, to me, the issue of personnel flow inside a facility treating a patient for Ebola is critical. Texas Health Presbyterian Dallas got that issue terribly wrong in the case of Thomas Duncan, and now, although they provide very good guidance on the issue of personal protective equipment and its use, new guidelines just released by CDC sadly fall short of correcting the problem I have highlighted.
The issue is simple and can even be explained on a semantic level. If a patient is being treated in an isolation ward, that isolation should apply not only to the patient but also to the staff caring for the patient. As I explained previously, National Nurses United complained that health care workers at Texas Health Presbyterian Dallas treated Duncan and then continued “taking care of other patients”.
Allowing care providers to go back to treating the general patient population after caring for an isolated patient is in direct contradiction to one of the basic recommendations by WHO in a document (pdf) providing guidance for treatment of hemorrhagic fever (HF, includes Ebola):
Exclusively assign clinical and non-clinical personnel to HF patient care areas.
By exclusively assigning personnel to care of the isolated patient, then the isolation is more complete.
The new CDC guidelines, released on Monday, offer updated recommendations on the types of personal protective equipment (PPE) to be used and how it is to be used. The guidelines also stress the importance of training on effective PPE use prior to beginning treatment of an Ebola patient. Unfortunately, though, the guidelines still leave open the possibility of health care workers moving between the isolation area and the general patient population.
In the preparations before treatment of an Ebola patient commences, the guidelines state:
Identify critical patient care functions and essential healthcare workers for care of Ebola patients, for collection of laboratory specimens, and for management of the environment and waste ahead of time.
And then once treatment begins, we have this:
Identify and isolate the Ebola patient in a single patient room with a closed door and a private bathroom as soon as possible.
Limit the number of healthcare workers who come into contact with the Ebola patient (e.g., avoid short shifts), and restrict non-essential personnel and visitors from the patient care area.
So the facility is advised to identify the “essential” workers who will provide care to an Ebola patient and to limit the number of personnel coming into contact with the patient. And even though the patient is to be in an isolated room, the guidelines still fall short of the WHO measure of calling for the Ebola treatment staff to be exclusively assigned. Precautions for safely removing the PPE are described, but once removed, the workers presumably are free to go back to mixing with the general patient population. Hospitals are cautioned against allowing large numbers of care providers into the room and to avoid “short shifts”, but there still is no recommendation for workers to be exclusively assigned to the isolation area.
The first thing that comes to mind in this regard is to question whether the CDC recommendations fall short of the WHO call for exclusive assignment in order to allow US hospitals avoid the perceived expense of dedicating a handful of personnel to treatment of a single patient. Is the ever-constant push to reduce personnel costs responsible for this difference between CDC and WHO guidelines? In the US healthcare system, it appears once again that MBA’s can carry more weight than MD’s on critical issues.
Back on Thursday, I noted that Iran claimed the right to enter Pakistani territory to chase terrorists that it blames for a series of border incidents that have killed a number of Iranian border guards. Iran wasted no time following up on that threat, as on Thursday night Iranian shelling killed one Pakistani soldier. Iran followed that up with border guards entering Pakistani territory on Friday to interrogate a number of villagers. It appears that Iran confiscated a vehicle and other items during the incursion. Diplomatic posturing ensued.
Interestingly, Pakistan claims that the Frontier Corpsman who was killed by Iran was in the process of chasing “miscreants” when the soldiers came under fire:
“The FC personnel were chasing miscreants when they came under attack by Iranian forces. It was a targeted attack on Pakistani forces,” the spokesperson added. One FC vehicle was completely destroyed due to intense firing by Iranian forces.
Iranian border guards continued firing for six hours. However, Pakistani forces did not retaliate to the offensive of the neighbouring country.
The big question is whether Iran feels that Pakistan’s Frontiers Corps is aiding the groups that cross into Iran or whether the Pakistani forces came under fire in this case through a mistake when they were chasing the same “miscreants” Iran presumably wished to target.
There was a small amount of additional cross-border shelling on Saturday that appeared to have no effect.
For their part, Iran does not seem to have addressed the events Thursday night through Saturday, although they did put out a statement today praising their strong security in the border region and comparing the terrorist attacks to “mosquito bites”. Iran blamed trans-regional enemies (the Americans and Zionists) as well as unnamed regional enemies for the attacks.
In an analysis of the flare-ups in Dawn, we see mention of the Jaish al-Adl group, Iranian concerns about development of the port at Gwadar and the tension caused by the border putting an artificial barrier through the heart of the regional home of the Baloch people.
But returning to the point above, it is hard to reconcile the statement from Pakistan that the Frontier Corpsmen who came under fire by Iran while chasing “miscreants” were intentionally targeted. While Iran sees Sunni extremists at the heart of their cross-border attack problems, there would seem to be significant overlap between those groups and the Baloch militants that the Frontiers Corps has long been subject to criticism for human rights abuses while trying to quash said militancy.
If Pakistan is indeed serving as a “regional enemy” of Iran in this case and supporting or providing refuge to some of the groups involved in the attacks on Iranian border posts, then Iran would seem to be justified in attacking the FC personnel. The fact that the FC did not return fire would seem to fit that scenario and serve as a tacit admission that they had been caught doing wrong. However, if the FC were chasing a group that intended a cross-border attack, then Iran would be the ones responsible for needless escalation.
As I noted in discussing the first reports of the explosion at Parchin, early September saw a larger than usual incident along the Iran-Pakistan border, with a force of over 70 militants and a truck packed with over 1000 pounds of explosives attacking an Iranian border station. Thomas Erdbrink then noted last week that two separate incidents along the border resulted in the deaths of “a senior officer” and “three police officers” in two separate incidents in the same region.
Iran is quite upset by these events and no less than the second in command of the IRGC is speaking out today, warning Pakistan that if they can’t control the terrorists in the border region, then Iran will have no alternative but to chase them, even in Pakistani territory:
Iran will step in to contain terrorists if Pakistan refuses to take measures in order to secure its borders to keep terrorists from slipping into the Islamic Republic, a senior Iranian military commander says.
“We believe that every country should respect its commitments vis-à-vis its own internal security as well as that of neighboring countries. Border security is a common and pressing need for neighboring countries. We are, in principle, against intervening in the affairs of any country, but if they fail to abide by their obligations we will have [no choice but] to act,” the second-in-command of the Islamic Revolution Guards Corps (IRGC), Brigadier General Hossein Salami, said on Thursday.
“Terrorists, wherever they may be, even on the soil of neighboring countries, we will find them, and if they do not give up acts of terrorism, we will deal with them without reservation,” the senior commander added.
Gosh, maybe the US should go to the UN or the ICC to complain about such a blatant violation of Pakistani sovereignty if such an attack takes place. Just as soon as the US stops violating Pakistani sovereignty with drones, that is.
The article goes on to quote Salami that Iran has very good intelligence on the terrorist groups in the border region and then notes that “Iranian security forces have apprehended a number of perpetrators behind the recent killings” regarding the incidents described in the Erdbrink report.
Gosh, with intelligence that good on the border zone terrorists, maybe Iran will start using drones in Pakistan, too. I can only imagine the chaos that would sow among the chattering classes inside the Beltway.
The incompetence of Texas Health Presbyterian Hospital Dallas is staggering. In following today’s rapidly developing story of a second nurse at the hospital now testing positive for Ebola, this passage in the New York Times stands out, where the content of a statement released by National Nurses United is being discussed (emphasis added):
The statement asserted that when Mr. Duncan arrived by ambulance with Ebola symptoms at the hospital’s emergency room on Sept. 28, he “was left for several hours, not in isolation, in an area where other patients were present.” At some point, it said, a nurse supervisor demanded that Mr. Duncan be moved to an isolation unit “but faced resistance from other hospital authorities.”
The nurses who first interacted with Mr. Duncan wore ordinary gowns, three pairs of gloves with no taping around the wrists, and surgical masks with the option of a shield, the statement said.
“The gowns they were given still exposed their necks, the part closest to their face and mouth,” the nurses said. “They also left exposed the majority of their heads and their scrubs from the knees down. Initially they were not even given surgical bootees nor were they advised the number of pairs of gloves to wear.”
The statement said hospital officials allowed nurses who interacted with Mr. Duncan at a time when he was vomiting and had diarrhea to continue their normal duties, “taking care of other patients even though they had not had the proper personal protective equipment while providing care for Mr. Duncan that was later recommended by the C.D.C.”
From the context of both the New York Times article and the nurses’ statement, it seems most likely that this movement of nurses from treating Duncan to treating other patients took place during the period after Duncan was admitted to the hospital and before the positive test result for Ebola was known. However, from the nurses’ statement showing that at least some of the personnel on duty realized Duncan almost certainly had Ebola, proper isolation technique should have been initiated immediately.
And that movement of nurses from a patient who should have been in isolation back into the general patient population is a huge, and obvious, error. Consider this publication (pdf) put out in August by the World Health Organization, summarizing precautions to be taken in care of Ebola patients. The very first page of actual content, even before the section labeled “Introduction”, is a page with the heading “Key messages for infection prevention and control to be applied in health-care settings”. The page lists nine bullet points about dealing with ” hemorrhagic fever (HF) cases” (hemorrhagic fever diseases include Ebola). Here is the third entry on that list:
Exclusively assign clinical and non-clinical personnel to HF patient care areas.
There really is no point in saying a patient is isolated if staff are freely moving back and forth between the isolation area and the general patient population. I’m wondering how long it will be until there is a whole new management team at Texas Health Resources, the parent firm for the hospital.
In a blockbuster story published last night by the New York Times, C.J. Shivers lays out chapter and verse on the despicable way the US military covered up the discovery of chemical weapons in Iraq after the 2003 invasion. Even worse is the cover-up of injuries sustained by US troops from those weapons, their denial of treatment and denial of recognition or their injuries sustained on the battlefront.
Why was this covered up, you might ask? After all, if George W. Bush would joke at the White House Correspondents’ Dinner about looking under White House furniture for Saddam’s WMD’s, why didn’t the US blast out the news of the WMD’s that had supposedly prompted the US invasion?
The answer is simple. The chemical weapons that were found did not date to the time frame when the US was accusing Saddam of “illegally” producing them. Instead, they were old chemical weapons that dated from the time Saddam was our friend. They come from the time when the US sent Donald Rumsfeld to shake Saddam’s hand and to grease the skids for Iraq to get chemical weapons to use in their war against Iran.
Chivers give us the details:
From 2004 to 2011, American and American-trained Iraqi troops repeatedly encountered, and on at least six occasions were wounded by, chemical weapons remaining from years earlier in Saddam Hussein’s rule.
In all, American troops secretly reported finding roughly 5,000 chemical warheads, shells or aviation bombs, according to interviews with dozens of participants, Iraqi and American officials, and heavily redacted intelligence documents obtained under the Freedom of Information Act.
The New York Times found 17 American service members and seven Iraqi police officers who were exposed to nerve or mustard agents after 2003. American officials said that the actual tally of exposed troops was slightly higher, but that the government’s official count was classified.
Then, during the long occupation, American troops began encountering old chemical munitions in hidden caches and roadside bombs. Typically 155-millimeter artillery shells or 122-millimeter rockets, they were remnants of an arms program Iraq had rushed into production in the 1980s during the Iran-Iraq war.
All had been manufactured before 1991, participants said. Filthy, rusty or corroded, a large fraction of them could not be readily identified as chemical weapons at all. Some were empty, though many of them still contained potent mustard agent or residual sarin. Most could not have been used as designed, and when they ruptured dispersed the chemical agents over a limited area, according to those who collected the majority of them.
But here is the real kicker:
Participants in the chemical weapons discoveries said the United States suppressed knowledge of finds for multiple reasons, including that the government bristled at further acknowledgment it had been wrong. “They needed something to say that after Sept. 11 Saddam used chemical rounds,” Mr. Lampier said. “And all of this was from the pre-1991 era.”
Others pointed to another embarrassment. In five of six incidents in which troops were wounded by chemical agents, the munitions appeared to have been designed in the United States, manufactured in Europe and filled in chemical agent production lines built in Iraq by Western companies.
Good old USA technology, conveniently exported to European firms that we helped to build factories in Iraq to produce chemical weapons to be used against Iran. That is what caused injury to US servicemen who were routinely denied care and quickly sent back into battle because they weren’t missing limbs. Chivers talked to a number of those soldiers and their stories are so consistent they nearly blend together. Also consistent was the instant classification of the injuries, presumably because of the embarrassment to the Bush Administration they would cause should the press look into them too rigorously.
Sadly, though, the story is not yet over. The US left Iraq in 2011, knowing that chemical weapons were still stored in bunkers at Al Muthanna. At the end of Chivers’ report: Continue reading