Thursday, October 16, 2014
Another Nail In the Coffin: Expecting Miracles
On another blog, in discussing the current outbreak (which is now probably approaching the #1 Internet topic) the possibility of a vaccine came up.
It was observed that pharmaceutical company press releases, including from GlaxoSmithKline (GSK), a British Big Pharma megacorporation with $11B annual profits, are supposedly going to be able to deliver the first 15,000 doses of an Ebola vaccine by December. (Whether that's Dec. 1st or 31st we'll set aside for the moment.)
So first, an assumption:
We'll grant, arguendo, that it'll work.
Not 50%, 90%, 95%, or 98%, but a full 100% efficacy.
Then, we'll further assume that they mean Dec. 1st, not Dec. 31st.
So now, let's look at what we'll be facing.
Currently, there are +/- 9000 Ebola cases in W. Africa (Guinea, Liberia, Sierra Leone).
And they double about every three weeks on average, currently.
So on Dec. 1st, we're looking at nearly 40,000 Ebola cases.
But they aren't the problem.
The problem is the people who haven't gotten it yet, for whom a vaccine would be useful, in order to halt the further spread.
Guinea: Population 11,474,383
Liberia: Population 4,092,310
Sierra Leone: Population 5,743,725
Oh, and lest we forget, there's a nifty little separate Ebola outbreak in Democratic Congo going on right now too. We're ignoring it in the main, because it's a separate event, and still rather small so far. But probably we want to nip that one before they get to 100 or 1000 cases, before it turns into Liberia 2.0, right?
Democratic Republic of Congo: Population 77,433,744
So our total target population to vaccinate immediately is 98,744,162.
(Less the 5,000 or so who've helpfully died of Ebola already, and another fraction who've survived Ebola, thus theoretically immune.)
So, those companies' 15,000 doses are going to be juuuuuuuuuuuust a little bit short.
But let's say they have the Mother Of All Production Lines, and they're going to make 15,000 doses a day!
Much better. At that rate, it would only take them 6,583 days (that would be NLT December 14th, 2032, before we have enough medicine just to dose the four critical populations).
Not so spiffy.
Okay, gonna need to ramp things up even more: 15,000 doses per HOUR!
Much, much better. Now they'll only need 274 days to get us the doses we'll need.
So, at current rate of Ebola spread, in 274 days where are we?
Everyone in Guinea, Sierra Leone, and Liberia already has Ebola, 70-90% of them are dead, their governments long-since collapsed, infected populations spread to the four points of the compass, and Africa is amidst a biblical continent-wide pandemic.
Which means we'll need another 1,000,000,000 doses right away just for Africa.
Of course, if it goes continent-wide in Africa, it'll probably have spread to cities like Cairo (pop. 7.7M) and over to South America, greater Arabia, Europe, and Asia, and that's before we start thinking about air travel to South and East Asia and North America.
Better just make the order 8B doses, to be safe.
And we'll ramp up production to 15,000 doses a MINUTE!!!
No sweat. Now they'll be able to carpet the world in only 370 days, which means with production at only 1,440 times, every minute the amount they'll produce currently in 6-10 more weeks, they'll be able to make enough for everyone, just a few months after Ebola has circled the world and killed some apocalyptically huge swath of humanity, perhaps as much as 90% of it, at least of those unvaccinated.
I'm thinking that at some moment ahead of that point in time, Ebola alone won't any longer be the most pressing concern on the planet.
And even the barest initial efforts will be directed at vaccinating populations in the most backwards, politically corrupt, medically under-served, and logistically unimproved and inaccessible portions of Africa, which is to say, anywhere in the world.
That will be like chipping away at an iceberg with a rock pick, which is how far beyond bad global lethargy and official indifference has let this situation get.
We won't even talk about if it turns our the vaccine is a flop.
It's nice to hope for miracles. But absent flocks of angels from heaven flying across the planet with healing in their wings, a vaccine solution alone isn't going to be much use if we can't isolate the disease now, and stop the spread very quickly, with far less fanciful solutions.
If you're a prudent person, plan ahead for other eventualities.