Putting Ebola in Context

Ebola:  Take It Seriously So You Won't Have to Worry USCDC

Ebola: Take It Seriously So You Won’t Have to Worry

As of 8 October 2014, approximately 4,000 people have died of the 2014 West African Ebola outbreak. From the CDC website:

As of October 8, 2014
(Updated October 10, 2014)

Total Cases: 8400
Laboratory-Confirmed Cases: 4656
Total Deaths: 4033

___ CDC 2014 Ebola Outbreak in W. Africa

Now let’s rank the top 10 killer viruses:

# 1 Human immunodeficiency virus (HIV)

Global deaths per year: 3.1 million

# 2 Rotavirus

Global deaths per year: 611,000 (NCBI)

# 3 Hepatitis B

Global deaths per year: 521,000

# 4 Influenza

Global deaths per year: 500,000

# 5 Hepatitis C

Global deaths per year: 500,000 related (56,000 directly attributable)

# 6 Measles

Global deaths per year: 197,000

# 7 Hantavirus

Global deaths per year: 70,000 (NY Times Health Guides)

# 8 Rabies

Global deaths per year: 55,000

# 9 Yellow fever

Global deaths per year: 30,000

# 10 Dengue

Global deaths per year: 25,000

  __ Top 10 Killer Viruses

Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent… In 2012, 8.6 million people fell ill with TB and 1.3 million died from TB. _ WHO TB

Estimated global mortality from malaria: 655,000

Ebola can be scary — causing many to quake in their boots. (via Outside in) Until this year, it was believed that there had only been 1,716 cases since 1976, when the virus was identified. This year alone, there appear to have been over 8,000 cases (over 4500 cases confirmed by lab testing). Roughly half of the infected cases have died in the 2014 outbreak.

Public health officials are caught in a political vice. Because this epidemic is taking place in Africa, it is not politically correct to quarantine the countries that are the source of the current outbreak. On the other hand, officials cannot reassure residents of western countries that everything is under control, because the virus is deadly, and with anything at all connected with Africa — nothing is under control.

Political correctness is a deadly weakness for modern western societies, in many ways. Refusing to protect its citizens in the name of political correctness is a particularly egregious offense for any government or governmental agency.

How Contagious is Ebola?

Ebola may yet leap out of its reservoir in rural Africa, and attack denser, more popular areas that are still too poor to mount an effective response in the face of an epidemic that is most likely to kill caregivers. That is, as Levin says, the greatest threat to billions of people in the developing world, and also to us. If the world stops this from happening, it will probably be because we got really scared of [serious about – ed.] Ebola, and took the steps we needed to make sure it didn’t spread. __ Megan McArdle

Ebola is not the end of the world. Assuming effective quarantine measures are instituted, this outbreak will burn itself out like all the others. We will need to determine why so many more people were affected this time, but the answer may be obvious.

As the ongoing sub Saharan African population explodes in size, forcing more and more impoverished people into overcrowded and unhygienic conditions, public health officials should expect infectious disease rates of all kinds to rise alarmingly — from a wide range of pathogens, including HIV and TB. A growing human population in Africa is probably impinging upon the wildlife habitats of the animal reservoir(s) of the Ebola virus, with “bush-meat” hunters and poachers at higher risk of contacting the virus in the wild.

The possibility that some of the viral spread within Africa was carried out by intention cannot be ruled out. And it is certain that viruses are constantly mutating, changing transmissibility, virulence, lethality, and other characteristics of phenotype along with genotype alterations.

Unless you live in sub Saharan Africa (or Russia), this is not the time to panic. But eventually, a more contagious disease with a longer silent incubation time and a higher mortality rate, will escape from Africa, Asia, or South America. And then, countries that pride themselves on the “openness” of their societies, will find the commons at deadly risk.

The laws of the jungle could easily accompany “jungle viruses” from their sites of origin to the more developed world, disrupting economic markets, commerce, transportation, institutions of education, and free assembly of all kinds. If broadcast facilities and the internet go down at the same time, you could be forgiven for thinking that it is then time to panic.

Not yet. But provisions should be made, just in case.



Ebola — Diagnosis and treatment

Canadian Ebola vaccine begins testing

Using convalescent plasma from Ebola survivors to treat active infection

Erwin Schmidt links to some useful articles on best approaches to the Ebola epidemic

More from the hard-core: http://drjamesthompson.blogspot.com/2014/08/solving-ebola.html

Gregory Cochran’s takedown of pseudo-expert Laurie Garret on travel quarantines In a global world, meaningful quarantines for serious infectious diseases are international in nature.

Note to readers: As I said above, Ebola is a deadly disease and has to be respected as such. But had basic quarantine measures been followed, the epidemic would have burned itself out months ago. It is the failure to treat Ebola seriously and the refusal to use sensible quarantine measures that have allowed levels of uninformed global hysteria to build.

Anyone who still misunderstands what I am saying should perhaps read this blog posting from James Thompson, if you have not already done so. While what he writes may seem harsh, it is a more suitable approach for Africa than what the foreign medical workers and NGOs have been trying.

More panic: If public health officials do not recover from the “epidemic of political correctness” this is what may happen …

Peter Piot, who helped discover and name the virus, told the Guardian about his concerns with an outbreak in India:

But an outbreak in Europe or North America would quickly be brought under control. I am more worried about the many people from India who work in trade or industry in west Africa. It would only take one of them to become infected, travel to India to visit relatives during the virus’s incubation period, and then, once he becomes sick, go to a public hospital there. Doctors and nurses in India, too, often don’t wear protective gloves. They would immediately become infected and spread the virus.

As Vox’s Julia Belluz previously explained, this is one of the nightmare Ebola scenarios that keeps scientists up at night. It’s good, then, that the chance of Ebola spreading to India and China seems fairly remote. ___ Vox

When anticipating the conversion of an “epidemic” into a “pandemic” one must consider viral reservoirs. Africa clearly has a viral reservoir for Ebola somewhere in the animal population. If fruit bats are the main reservoir, the virus might have already traveled via fruit bat to tropical parts of South Asia, such as Bangladesh. There is slim evidence for that speculation. A quarantine against the international trade of all potential Ebola reservoirs makes sense. Stronger measures against particular animal populations may be necessary as we learn more, if public health officials cannot re-learn basic quarantine and disease eradication procedures.

If you are deeply concerned about a possible killer virus epidemic in your area, consider being trained in TEOTWAWKI preparedness. If you know that you can handle the worst that can happen, everything else should be easy.

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4 Responses to Putting Ebola in Context

  1. GoneWithTheWind says:

    You may be correct. But you are missing a very important piece of the picture. In the very early days of a pandemic even the worst pandemic that ever happened you could make exactly the same point. BUT the correct time to get serious and try to stop or turn an epidemic around is in the early days, as early as possible. So if we wait until there are a million ebola deaths and 100 different countries to decide “hey this might be serious” we will have waited too long. So depending on how this epidemic proceeds either the “don’t worry, calm down” side is right OR the “do something now, take it serious” crowd is right. Which error do you think is the worst???

    • alfin2101 says:

      I don’t recall saying “don’t worry, calm down,” although for those prone to hysterics that may be the proper thing to say. “Don’t panic” is a call to action, not a call to paralysis.

      But perhaps I didn’t make myself clear. Ebola is a serious disease and holds a significant threat to primitive countries — and those advanced countries too foolish to know when to quarantine primitive countries that are in the throes of a killer epidemic such as Ebola.

      But Ebola is not even close to being the worst threat that Africa faces, let alone the more developed world.

      I am saying that no one has gotten serious about Ebola, which is the reason that global fear has been allowed to rise so high. If people rightly perceive that the authorities are holding back for reasons of political correctness, they need to consider bringing the guillotines out for the authorities.

      Doomers are a dime a dozen. We need to be problem solvers.

      BTW, the current African Ebola epidemic started almost a year ago. One of the reasons it is still dragging on is the “good intentions” of foreign medical workers and NGOs, who may have taken precisely the wrong actions required to nip it in the bud.

      The animal reservoir for Ebola is not clear. If humans cannot serve as a reservoir — which seems to be the case — then tough-minded public health measures can stop the epidemic. Obviously, those measures have not yet been taken, primarily for political reasons. If those responsible for this laxity were lined up against the wall, would you shoot them? A tough call.

      I recommend reading the ideas of James Thompson on this topic. His solution sounds harsh, but it is probably what Africa needs.

  2. bob sykes says:

    This morning it is reported that a second care-giver at Texas Presbyterian has come down with Ebola. This makes 2 out of 70, or 3%. So far. No word yet as to Duncan’s friends and relatives or cleanup crews or others who had contact with Duncan.

    What is striking is the immense resources that were expended on one Ebola patient and the surprisingly high rate of contamination of care-givers. It would appear that the resources of a major hospital are needed to respond to one patient. Even then, the resources were inadequate to prevent the spread of the disease. Note also the immense response yesterday at Boston’s Logan Airport when five passengers on an inbound flight reported flu-like symptoms. There were at least a dozen people in full hazmat suits on site, and the plane was quarantined.

    Despite Frieden’s lies, the Texas Presbyterian medical staff was clearly unprepared to recognize or treat Ebola, and the hospital admits that its staff were learning the CDC protocols on the fly. No doubt this one incident will improve awareness and training, but Murphy’s Law is always in force. And the CDC will continue to lie and to prevent the use of quarantines for purely ideological reasons. The government cannot be trusted in this matter, or any matter.

    It is also notable that the hospital’s ER had to be closed because many orderlies and nurses called in sick. The work stoppage has allowed the hospital to decontaminate its ER. It has also closed its cafeteria. In a panic, many care-givers will stay home, and the ability of the system to handle patients will be seriously degraded.

    I doubt a major epidemic will occur, and North America and Europe probably do not have potential animal reservoirs that would allow the permanent establishment of the disease there.

    However, if we get a low but steady rate of Ebola, our current care system will be severely stressed. It cannot handle more than a few cases nationwide. There are supposed to be four dedicated Ebola hospitals in the US, but they are not being used. If health workers panic, the system will collapse, not only for Ebola patients but for all patients.

    • alfin2101 says:

      Right. Ebola is not nearly as contagious from human to human as many of our more common viral companions. But conditions inside many big city hospitals can be positively medieval.

      Large institutions are often slow to adapt to new threats. That is especially true when labyrinthine government policies become integrated into such institutions. Big unwieldy government equals paralysis, as we can see in so many sectors of society.

      The concept of the “animal reservoir” is crucial to understanding zoonotic viruses — or viruses that spread from animal to human. Viral doomers who are panicked over Ebola apparently do not understand the international limits of Ebola spread — if even the rudiments of public health epidemic precautions are followed. All bets are off if public health measures are not undertaken.

      Sure you can see a handful of cases spread by travelers from endemic regions — especially where isolation procedures are sketch or slow to be put in place. But Ebola does not travel through inter-dimensional wormholes to strike its victims. Simple barriers stop it, although the virus can live outside the body for a while. Fire kills it, though.

      In Africa, the measures that are needed to stop Ebola cold are simple and inexpensive. Fatalism helps immensely. Keeping western missionaries, NGOs, and other medical workers away would also help.

      I don’t blame Frieden so much as his political higher ups, who told him what he couldn’t say. A stronger man might have resigned and taken his chances in the non-government sector, but Chicago politics in the US has a long reach these days.

      A killer global pandemic is not out of the question — whether engineered in the lab or engineered by nature. But unless Ebola is weaponised significantly, I don’t expect it to be the one.

      Ebola is telling us some important things about our medical and public health infrastructures, however. We are vulnerable. Our commons is vulnerable.

      HFTB. PFTW. It is never too late to have a dangerous childhood.

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