Hey, you want to read some really freaky speculative-future Tweets about Ebola coming to the US? Read @TheRickWilson right now.
— Rick DeVos (@RickDeVos) July 28, 2014
https://twitter.com/Tyler_McNally/status/493770640378564609
If Ebola is your greatest fear, like it is mine, mute @TheRickWilson right now.
— Bethany S. Mandel (@bethanyshondark) July 28, 2014
In Liberia, two Americans have tested positive for the Ebola virus. The current outbreak has killed more than 660 people in four West African countries.
What if the virus were to spread? @TheRickWilson tells a story that is for now, thankfully, fictional:
A thought experiment: Tomorrow, someone without frank symptoms of Ebola will get on a plane from Lagos, or Conakry, or Monrovia. 1/
— Rick Wilson (@TheRickWilson) July 28, 2014
He's an engineer in the oil and gas industry, educated in the States. He'll come legally, as he has a dozen times before. /2
— Rick Wilson (@TheRickWilson) July 28, 2014
Educated in the states, smart, Westernized. But 5 or 6 days ago, he was exposed to Ebola. Doesn't know it, of course. /3
— Rick Wilson (@TheRickWilson) July 28, 2014
No outward sign. He'll pass through Heathrow or Charles De Gaulle on his way to JFK. He'll be through customs within the hour. /4
— Rick Wilson (@TheRickWilson) July 28, 2014
Headache? Has to be the jet lag. Always is. Is he feeling his best when he get in the cab? checks into his hotel, and rests. /5
— Rick Wilson (@TheRickWilson) July 28, 2014
Next a.m., the sun shining through the narrow slit in his hotel curtains is blinding and painful. He's got meetings today. /6
— Rick Wilson (@TheRickWilson) July 28, 2014
He swallows a handful of Tylenol and stands in the shower until his head clears a little. /7
— Rick Wilson (@TheRickWilson) July 28, 2014
His day goes downhill, with the headache roaring back. A lunch he excuses himself, racing to the bathroom to vomit. /8
— Rick Wilson (@TheRickWilson) July 28, 2014
By late afternoon, he's feverish, racked with pain in his back. His guts are like liquid fire. /9
— Rick Wilson (@TheRickWilson) July 28, 2014
He googles for the nearest walk-in clinic. He's still trying to get work done on while he sits for 2 hours in the crowded waiting room. /10
— Rick Wilson (@TheRickWilson) July 28, 2014
The sudden spike in his fever hits, and he vomits without warning, this time on lap of his fellow waiting room patient, he's shocked. /11
— Rick Wilson (@TheRickWilson) July 28, 2014
It's…bloody. /12
— Rick Wilson (@TheRickWilson) July 28, 2014
The woman shrieks, grabs her ear-infected kid with her into the bathroom, panicking. Not, if she knew, panicking enough. /13
— Rick Wilson (@TheRickWilson) July 28, 2014
Now, the Doc-In-A-Box staff knows this guy is sick. They hustle him back, helping to clean him up. Gloves, but not masks at this point. /14
— Rick Wilson (@TheRickWilson) July 28, 2014
He's having trouble making himself understood the fever is so high. But hey, it's a pretty bad flu season… /15
— Rick Wilson (@TheRickWilson) July 28, 2014
The doc, a grad of a decent medical school in the midwest rolls in after the two nurses have cleaned him a bit and takes his vitals. /16
— Rick Wilson (@TheRickWilson) July 28, 2014
There's an important moment happening out in the waiting room. Ear-infection mom and her toddler? Tired of waiting. They've gone home. /17
— Rick Wilson (@TheRickWilson) July 28, 2014
The doc doesn't see a lot of cases like this. At all. He walks out of the room, unconsciously shoving his gloves into his pocket. /18
— Rick Wilson (@TheRickWilson) July 28, 2014
Now, there are a whole bunch of CDC and DHS rules about early identification of outbreaks, and reporting thereof. But our doc? Come one. /19
— Rick Wilson (@TheRickWilson) July 28, 2014
90% of his cases are sprains, trivial cuts, kids with ear infections, flu shots. He refers to a local ER for real trouble. /20
— Rick Wilson (@TheRickWilson) July 28, 2014
This guy is spiking 103, is in distress. Obviously the flu, just a bad case. He walks out, washes his hands, and will make the call… /21
— Rick Wilson (@TheRickWilson) July 28, 2014
…right after he looks at little Johnny's split lip, tells Mrs. Gomez antibiotics don't help ear infections but prescribes one anyway. /22
— Rick Wilson (@TheRickWilson) July 28, 2014
He's on calling when he hear loud, distressed shouts. The patient is standing in the hall, bloody diarrhea running down his pants leg. /23
— Rick Wilson (@TheRickWilson) July 28, 2014
It's a mess. His two nurses and one orderly are trying to help get the patient in hand. He hangs up, dials 911. /24
— Rick Wilson (@TheRickWilson) July 28, 2014
The nurses and orderly are scrubbing down. The floor is a mess. A departing patient skirts the visible mess, but maybe not entirely. /25
— Rick Wilson (@TheRickWilson) July 28, 2014
Midafternoon traffic is a bitch, and the ambulance takes 24 minutes to arrive. The patient is quiet again, whispering for water. /26
— Rick Wilson (@TheRickWilson) July 28, 2014
The EMT's know something is off about this one. One of them had spent time in Africa with MSF. Still not thinking "ebola." /27
— Rick Wilson (@TheRickWilson) July 28, 2014
Now, Mercy General's ER procedures are a lot better. A lot. But there's still a hell of a mess in the back of the bus and in the ER. /28
— Rick Wilson (@TheRickWilson) July 28, 2014
Because non-trauma cases get bumped down, a doc sees him for minutes, thinks flu, and rushes to work an accident victim. /29
— Rick Wilson (@TheRickWilson) July 28, 2014
Did I mention the hotel maid? She's cleaning the mess in room 618. She's got on Playtex gloves, but does wipe her brow… /30
— Rick Wilson (@TheRickWilson) July 28, 2014
The doc at the walk-in surveys the mess of his day, and the cleanup continues, He fleetingly remembers the CDC disease reporting rules. /31
— Rick Wilson (@TheRickWilson) July 28, 2014
But it was just flu, and the guys at Mercy will report it if its serious, right? /32
— Rick Wilson (@TheRickWilson) July 28, 2014
Meanwhile, our patient is on a gurney, on fluids. He's hallucinating like a bitch and fever-shouting. /33
— Rick Wilson (@TheRickWilson) July 28, 2014
He rolls his head to the side, and vomits out what looks to be mostly blood. Now there's a moment where some smart doc says… /34
— Rick Wilson (@TheRickWilson) July 28, 2014
"Get Patient X into isolation, stat." Nurses do masks and gloves, and roll him into an isolation room. It's not hermetic…just a room. /35
— Rick Wilson (@TheRickWilson) July 28, 2014
Cleanup on aisle 2 in the ER. They're careful, because it's blood. They're scared because it's…chunky. /36
— Rick Wilson (@TheRickWilson) July 28, 2014
They get blood panels running. No one has said the word, "Ebola." But now there's a weird feeling in the air. This isn't typical ER work /37
— Rick Wilson (@TheRickWilson) July 28, 2014
At a break, one of the docs says, "How do we report a suspected infectious disease again? Isn't there a website?" /38
— Rick Wilson (@TheRickWilson) July 28, 2014
One of the ER docs has training on the CDC's NORS system, but it's his day off. They ask around, an hospital legal gets wind of it. /39
— Rick Wilson (@TheRickWilson) July 28, 2014
The admin and the GC say, "Hey wait for blood work to come back in first. No need to start a panic. Don't want our ACA score dinged." /40
— Rick Wilson (@TheRickWilson) July 28, 2014
So Patient X is in isolation, feverish, given fluids, plenty of care. Staff gets a virologist/epidemiologist consult ordered in. /41
— Rick Wilson (@TheRickWilson) July 28, 2014
Virologist hears symptoms over phone, but the staff doesn't go into detail. When he arrives and gets briefed, he turns pale and says, /42
— Rick Wilson (@TheRickWilson) July 28, 2014
"You called CDC, right?" Blank stares. Whoopsie. He calls CDC, tries to find the right person. Too late in the day. Leaves messages. /43
— Rick Wilson (@TheRickWilson) July 28, 2014
Because it doesn't work like the movies. There's not perfect knowledge, and instant comms in or out of govt. It's always a mess. /44
— Rick Wilson (@TheRickWilson) July 28, 2014
It's always chaotic. All those CDC/HHS/DHS plans? NO one has read them. NO one is ready. Now, let's get to the fun part. /45
— Rick Wilson (@TheRickWilson) July 28, 2014
In the course of this day, there are probably a dozen people exposed. They go home. They're fine for a few days or a week. /46
— Rick Wilson (@TheRickWilson) July 28, 2014
Some won't come down with a thing. But a half-dozen will. And remember, this isn't the movies. The CDC isn't SEAL TEAM EBOLA. /47
— Rick Wilson (@TheRickWilson) July 28, 2014
Few days later, the unlucky are starting to feel like hell. But ear-infection mom isn't going to cancel that trip to Disney for anything /48
— Rick Wilson (@TheRickWilson) July 28, 2014
The orderly? He and his girlfriend are trying to get pregnant. The maid? Family reunion. The walk-in doc? Going to Chicago to see mom. /49
— Rick Wilson (@TheRickWilson) July 28, 2014
Around the same time, the CDC confirmed it was Ebola Zaire, same clade as hitting now in Africa. They tell HHS, who tells the WH COS. /50
— Rick Wilson (@TheRickWilson) July 28, 2014
(Oversimplified, I know.) This is happening just outside New York. Can't panic folks? Gotta keep the market running, amirite? /51
— Rick Wilson (@TheRickWilson) July 28, 2014
WH asks CDC to confirm the results. CDC steps up its game and tries to walk back Patient X's timeline, trying to isolate contacts.
— Rick Wilson (@TheRickWilson) July 28, 2014
But it's getting late in the game. Family members are helping their sick relatives suffering from this terrible flu. /52
— Rick Wilson (@TheRickWilson) July 28, 2014
But life isn't a movie. The CDC finds two of the contacts, but misses the rest. The news leaks. The Governor is in a fury that he was… /53
— Rick Wilson (@TheRickWilson) July 28, 2014
…kept in the dark over CDC teams in his state looking for fucking EBOLA. It was a mistake. Staff thought CDC said it was an exercise. /54
— Rick Wilson (@TheRickWilson) July 28, 2014
That's the rule: everything is chaotic. No plan survives contact with reality. Govt agencies have bad comms. Life. is. not. a. movie. /55
— Rick Wilson (@TheRickWilson) July 28, 2014
It leaks, right around day 11. Leak to the NYT. Twitter's #Ebola tag trends, and doesn't stop. Rumors fly. Republicans blame Obama. /56
— Rick Wilson (@TheRickWilson) July 28, 2014
Democrats deny that Ebola exists, and if it does, it was made by the Koch brothers, and racism. /57
— Rick Wilson (@TheRickWilson) July 28, 2014
Because every damn thing is political. /58
— Rick Wilson (@TheRickWilson) July 28, 2014
Media flood the zone, reporting in full Racal suits. Rumors fly like mad. The markets crap the bed for two days. The Fed steps in. /59
— Rick Wilson (@TheRickWilson) July 28, 2014
Social media and email are flooded with Ebola spam. "The one weird trick to stop hemorrhagic fevers!" /60
— Rick Wilson (@TheRickWilson) July 28, 2014
Meanwhile, our infected are dying. They infect another tranche of health care workers, docs, EMTs, family members. /61
— Rick Wilson (@TheRickWilson) July 28, 2014
The hotel workers, orderlies, cleaning staff, and others don't go to the docs. Some because of immigration, some due to lack of coverage /62
— Rick Wilson (@TheRickWilson) July 28, 2014
They tend (broadly) to live in multigeneration, multifamily close contact environments w internal social cohesion. Outsiders no bueno. /63
— Rick Wilson (@TheRickWilson) July 28, 2014
So it starts tearing through whole families at once. Those who do seek help are crowding the (diminished) ranks of Medicaid docs. /64
— Rick Wilson (@TheRickWilson) July 28, 2014
There comes a moment about a month in where the media coverage is getting terrifying. The clusters are in Newark, Philly, and Phoenix. /65
— Rick Wilson (@TheRickWilson) July 28, 2014
The disease, as it tends to, eventually succumbs to its own burn rate, but only after +/- 650 die. /66
— Rick Wilson (@TheRickWilson) July 28, 2014
It tapers off, rather than switches off. /67
— Rick Wilson (@TheRickWilson) July 28, 2014
Frontline health care folks are exhausted. They all need some time off. Which is why Nurse X want's to shake this headache. /68
— Rick Wilson (@TheRickWilson) July 28, 2014
She's really, really looking forward to seeing her abuela in Mexico City this weekend. /69
— Rick Wilson (@TheRickWilson) July 28, 2014
So endeth the lesson. Thank you for your kind comments, one and all. /70
— Rick Wilson (@TheRickWilson) July 28, 2014
Now, I need to get my bleach shower set up, and check on the oxygen system.
— Rick Wilson (@TheRickWilson) July 28, 2014
@TheRickWilson’s story caused some to think about isolation:
https://twitter.com/Tyler_McNally/status/493772644215701504
@TheRickWilson I'm never going outside again.
— Sarah (@mamaswati) July 28, 2014
@mamaswati @TheRickWilson Time to build that Y2K house I never got around to in 1999.
— Seth (@dcseth) July 28, 2014
Editors note: This story has been updated to include additional tweets.
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