mikepepler wrote:I've been thinking about what it would take for ebola to cause a problem in the UK, and I think it all comes down to how our health system copes. The rationale behind it not being a problem here is based on our advanced medicine, but if that system becomes stressed to the point that ebola patients either can't get into hospital, or can't be treated by people with the right level of training and equipment, then we're headed for trouble.
So, we know that the UK can cope with two ebola patients at once with almost zero risk, due to the excellent facilities at the Royal Free Hospital. We also know that several other major hospitals are ready to treat ebola patients, albeit with slightly less comprehensive isolation and probably slightly less well trained staff. So perhaps we can cope with 20 simultaneous cases, maybe 30? But what if we get to the point that we have 50, or 100?
There's not much slack in the NHS, either in hospitals or ambulance services. If we had 100 ebola patients, not only do you have a growing risk of infections of medical staff (simply due to numbers involved and lack of experienced staff), you also have huge resources tied up in looking after them. If every ambulance transporting a possible ebola case has to go for a deep clean afterwards, that keeps them off the road for a while. How long then before people decide to transport sick relatives to hospital in their own vehicles, as is happening in West Africa?
If we get to the point that significant numbers of medical staff get infected, then we really have a problem, as we not only have extra cases, we also have fewer medics to deal with them. Again, exactly what is happening right now in West Africa.
The only solution is to deal with the outbreak in West Africa, but as we all know, the resources to do that have not yet been provided, and the requirement is growing faster than the pledges of support. We're left depending on a vaccine which doesn't yet exist to put a stop to it. But all other efforts to contain the virus should still be made, as they can at least slow the spread, even if they can't halt it.
Meanwhile, countries like the UK should be training all the front line medical personnel to be ready to rapidly and effectively deal with the cases that will pop up here. I'm not yet convinced that sufficient training is being given to all the staff who might be the first to encounter an ebola patient.
That is a pretty good assessment of the threat, yes. The critical point, whether it is in West Africa or the UK, is when the health system can't cope with the number of infections, and in both cases that is well below 1000 cases in any urban area. Maybe below 100.
Looked at in terms of a global system, the outlook is very dangerous. If this virus can't be contained in West Africa, and is destined to cause serious epidemics in many of the large "megaslum" cities elsewhere, then there is going to be a continual stream of infected persons arriving in the developed parts of the world. This will slowly erode our capability to cope with it - it is like the virus gets an unlimited number of attempts to get us, and we only have to get the response wrong once for it to succeed.
I still believe it could, in principle, be contained in West Africa. Clearly several people here disagree with me, and they may be right. If they
are right, then I think the whole (human) world is in deep trouble, because this virus is easily capable of taking out upwards of a billion humans before a vaccine becomes widely available.
