Ebola outbreak, and other potential epidemics

[UndercoverElephant]

http://www.nytimes.com/2014/09/12/opini ... .html?_r=1

So... it is being said... air transmission...

But still no mention about seasonal flu or malaria, which I think is the next big threat, unless some one knows better.

I think the biggest threat is not that ebola starts being transmitted via insects - which may or may not happen, we just don't know. What we do know is that the where ebola has taken hold, the health services are in total chaos dealing with that problem and a significant proportion of the staff have died, and that means that the normal response to other health problems, including flu and malaria, is simply not going to be there. Plus everyone is going to be terrified of going anywhere near a hospital anyway. If you were pregnant, and about to give birth, and you had to choose between going to a hospital full of sick, possible ebola cases, or giving birth at home, which do you think would be the bigger risk? I think I'd take my chances at home, personally.

Ebola isn't just going to kill directly. It's going to lead indirectly to the death of millions of people who never actually catch ebola, from flu, malaria and god knows what else.

[UndercoverElephant]

http://www.nytimes.com/2014/09/13/world ... ebola.html

The deadly Ebola outbreak sweeping across three countries in West Africa is likely to last 12 to 18 months more, much longer than anticipated, and could infect hundreds of thousands of people before it is brought under control, say scientists mapping its spread for the federal government.

Again, where do they get this 12-18 month figure? This is uncharted territory. They have no way of knowing whether it can be brought under control at all, let alone how long it will take. Might as well just throw darts, blindfold.

[adam2]

Yes, and apart from lives lost from other diseases, I would expect a significant in deaths from famine as crops go un harvested for want of labour, and the next seasons crops go unplanted.
Large scale civil disorder with direct loss of life from violence and indirect loss of life from lack of public services is probable.

Collapse of law and order will also increase deaths from ebola as the sick roam at will rather than be quarantined.

[UndercoverElephant]

http://www.dailymail.co.uk/health/artic ... break.html

A 'treatment' for Ebola made from the blood of survivors of the vicious disease is being traded on the black market in West Africa, it has emerged.

Health experts have warned the serums could contain other harmful infections as the World Health Organisation vowed to work with governments to stamp out the illicit trade.

The 'convalescent serum' is made from survivors' blood, which contains antibodies that could help fight the virus, Bloomberg News reported.

Margaret Chan, director-general of the WHO said: ‘There is a danger that such serums could contain other infections and wouldn’t be administered properly.'

Right. So there's a black market trade in unregulated, "raw" blood transfusions? This is on the same continent where up until recently, one of the biggest threats to health was HIV.

[UndercoverElephant]

And...

http://www.aljazeera.com/news/africa/20 ... 59279.html

Local workers have gone on strike in an overcrowded Ebola ward at a major district hospital in Sierra Leone's disease-stricken east over claims the government is failing to pay them.

Up to 80 workers crowded the entrance compound to the hospital on Friday, deserting their posts and bringing operations at the Ebola treatment ward to a standstill. The workers were peaceful but frustrated.
The action comes after several other strikes at the same hospital by staff protesting poor working conditions, infection rates among colleagues and rates of pay they say do not make up for the risks they take.

This is mind-bogglingly bad.

[vtsnowedin]

And...

http://www.aljazeera.com/news/africa/20 ... 59279.html

Local workers have gone on strike in an overcrowded Ebola ward at a major district hospital in Sierra Leone's disease-stricken east over claims the government is failing to pay them.

Up to 80 workers crowded the entrance compound to the hospital on Friday, deserting their posts and bringing operations at the Ebola treatment ward to a standstill. The workers were peaceful but frustrated.
The action comes after several other strikes at the same hospital by staff protesting poor working conditions, infection rates among colleagues and rates of pay they say do not make up for the risks they take.

This is mind-bogglingly bad.

UC: I'm more often then not at odds with you on whatever issue we are discussing but on this issue I think your spot on.
The question is what can you or I do to improve the situation both in the effected areas and at home in anticipation of it getting much to close to home for comfort.

[UndercoverElephant]

The question is what can you or I do to improve the situation both in the effected areas...

Absolutely nothing. There is nothing anybody can do now to stop the spread of this disease. All we could do is slow it down a bit, but that's not going to make a whole load of difference to anything at all.

...and at home in anticipation of it getting much to close to home for comfort.

In the last two weeks there has been a very obvious response in terms of trying to find new treatments. The normal rulebooks for drug development have been thrown out the window. Six months ago ebola was pointless as far as western drug companies were concerned, because it was an intermittent disease affecting tiny numbers of people in some of the poorest places on Earth. Now people like you are worried about it arriving somewhere close to home.

Nobody knows what is going to happen - that's the scariest thing about it. It could mutate in all sorts of ways. We might find a vaccine, or a cure. And we might not. Or we might find one and then the virus mutates quickly to defeat the cure/vaccine. We humans like to be in control over mother nature. Well, this time we aren't.

[vtsnowedin]

The question is what can you or I do to improve the situation both in the effected areas...

Absolutely nothing. There is nothing anybody can do now to stop the spread of this disease. All we could do is slow it down a bit, but that's not going to make a whole load of difference to anything at all.

...and at home in anticipation of it getting much to close to home for comfort.

In the last two weeks there has been a very obvious response in terms of trying to find new treatments. The normal rulebooks for drug development have been thrown out the window. Six months ago ebola was pointless as far as western drug companies were concerned, because it was an intermittent disease affecting tiny numbers of people in some of the poorest places on Earth. Now people like you are worried about it arriving somewhere close to home.

Nobody knows what is going to happen - that's the scariest thing about it. It could mutate in all sorts of ways. We might find a vaccine, or a cure. And we might not. Or we might find one and then the virus mutates quickly to defeat the cure/vaccine. We humans like to be in control over mother nature. Well, this time we aren't.

The times we have been in control in actuality have been few and far between.

[madibe]

My personal worry is that I work in Higher Education and every fecking year we (the staff) all get "freshers flu" which is basically a massive influx of every known cold/flu virus from around the UK and globe.

Now the threat of Ebola (although hopefully slight) is a bit of a worry.

The WHO and UK Health have passed info onto VC's of Unis in the UK... but *NOTHING* has been passed onto the staff. There are procedures and warnings, but as I say, nada has been mentioned to staff. Not even a hand cleaning gel as was provided during the last health scare (swine flu / bird flu).

I think that they don't want to panic the troops.

[fuzzy]

Bingo, stiff upper lip etc...

Lets face it adult education and travel would be shut down if there was any number of cases taken seriously in the UK.

This should help focus the mind:

http://www.youtube.com/watch?feature=pl ... UBpoyKxArU

[madibe]

Yup, seen that video.

However, what we don't want is people dying on the streets - so a 'stiff upper lip' is not very productive fuzzy.

Education and travel would be shut down if there was a massive outbreak - fo sure bro - LOL, but by then it is a little to late for those on the front line.

My mind is focused - and exactly why I am asking questions and showing concern.

[UndercoverElephant]

This should help focus the mind:

http://www.youtube.com/watch?feature=pl ... UBpoyKxArU

And that is the result of infections that took place three to four weeks ago, before the hospitals were filled to capacity. They were infections from "the ones that got away" - both those who never tried to get admitted to a hospital and the 30 who were "liberated" by a gang of armed men who didn't believe ebola is real. Now we have people being turned away at the hospital door, and no doubt hundreds or thousands who aren't even bothering to go to the hospitals, because they know they will not be admitted.

So what will be happening in four weeks time, when all the people currently being infected start getting sick, and the hospitals are still full (even though they've been expanded a bit) and the staff are either dead or refusing to work?

It is obvious this is still early days, not just in terms of the numbers but in terms of how the outbreak unfolds. Four weeks from now, instead of a few hundred, or the low thousands, of infectious, dying people not being quarantined/hospitalised, there are going to be thousands of them. And at that point the whole system breaks down - the healthcare workers might as well just go home and give up, because they are risking their own lives for no apparent reason. And what happens after that? I guess that every person left inside liberia who isn't sick will want to escape that country, but every effort will be made to prevent them from doing so. But that's the very last ditch. If significant numbers of people manage to escape then the same scenario will inevitably be repeated elsewhere.

The lesson of this story is quite clear: you only get one chance to keep ebola under control in a given territory. As soon as it gets ahead of your ability to quarantine ALL potentially infected individuals (not just those already sick), then you're stuffed.

What does that mean for the developed world? If we didn't know it already it means that we have to be uber-vigilant watching for that first case, and if/when it happens then we throw everything, including the kitchen sink, at it. And at a University that means closing down the entire campus for a month, and instructing every single person who might have had contact with the infected person to stay at home and avoid contact with all other people.

[UndercoverElephant]

http://www.bbc.co.uk/news/world-africa-29196367

Liberian President Ellen Johnson Sirleaf has sacked 10 government officials who have been "out of the country without an excuse," amid a national Ebola crisis.

She said the officials had shown "insensitivity to our national tragedy and disregard for authority".

The 10 were given a one-week ultimatum more than a month ago to return home.

Officers leaving the sinking ship.

[nexus]

What does that mean for the developed world? If we didn't know it already it means that we have to be uber-vigilant watching for that first case, and if/when it happens then we throw everything,

Yes and with an up to 21 day incubation period how many thousands of people will that person have had passing contact with?

Does anyone here know the Ro number for Ebola- the only research I could find is 14 years old - the Ro estimate for Uganda in 200 was 1.34 and was 1.83 for the Congo in 1995. Due to the number of unreported cases epidemiologists can only give a best estimate for this figure.

[madibe]

I believe the Ro number is 1.7

I read it the other day, but can't remember the source.