Tuesday, October 21, 2014

Ebola Update: Remain Calm...

1) New (Oct. 17) Ebola numbers are out. Officially 9,693 total cases and 4,811 deaths. Liberia's missing numbers showed up: there is more Ebola in just Liberia alone, right now, than there was in the entire world on September 8th. All of which overlooks that they can't even keep track of the living or the dead, or issue death certificates fast enough as they cart them by the truckload to incineration.
Also, Liberia has (as of Oct. 12th) 620 treatment beds. Even if we built overnight the 1700 promised clinic beds we've only started on, it would barely be enough now (ignoring that there is no staff for any of those planned clinics yet). By the time they're actually finished, in another month, Liberia alone will have added another 2000 cases, and the region another 10,000. We can never catch up at this rate.

2) Riots and gunfire against troops leads to curfew in Sierra Leone town. Five months into their part of this epidemic, locals are still in denial that it's real, and some of them shot at troops trying to take a woman for Ebola testing. This happens a week after a Sierra Leone military medic tested positive for Ebola. That put the move of an 800-man UN peacekeeping mission by Sierra Leone to Somalia on hold. When Somalia won't take your troops, you're in trouble. When the locals are willing to shotgun them, you're losing your grip on any sort of order. This comes ten days after international medical officials, including the CDC, threw in the towel on ever getting ahead of Ebola in Sierra Leone. The country has nowhere to go but downwards, and when the government cracks and all order is lost, refugees will flood Guinea and Liberia, which could cascade the same effects on their control and order, blow up the whole thing, and send refugees in Cote d'Ivoire, Mali, Senegal, and Guinea Bissau, the next ripples in the pond. Which will also put the pitifully few workers in the three afflicted countries in immediate threat, and it won't do anything to help the still token US military contigent in Liberia. This could trigger yet another military and diplomatic crisis, of precisely the type that this administration has shown zero ability to deal with in nearly 6 years, inclusive.

3) As Michael Osterholm noted in remarks previously linked from this blog, there is absolutely no "Plan B" contingency for what to do if, or rather when, Ebola break the current three-country borders, and spreads into Central Africa, and such isn't even on anyone's radar at this point. The current total lack of reported cases in neighboring countries (with borders so notably porous that blocking flights from them is considered to be a waste of time by TPTB in Washington D.C.) points to the likelihood that there are cases there, and that they're being covered up, and reports squelched by those governments, lest they be added to the list of "Ebola-infected" nations and stigmatized, blockaded, and quarantined by every sensible country on the planet. Which points to any or all of them sooner or later, reporting an outbreak that will be well off to the races before anyone even acknowledges it exists.

4) If December clinical trials go well, WHO hopes to vaccinate 20,000 health workers in West Africa with experimental Ebola vaccines by sometime in January, and a similar number of people in subsequent months. Which is two ifs away from reality, and also overlooks that such a rate would enable them to blanket West Africa with people vaccinated against the disease - by May of 2097. At current disease spread rates, all of West Africa will be a ghost town with 70-90% dead (that would be 14-18M people) as early as May or as late as September of 2015, unless there's some hitherto unheard of gamechanger in current control efforts. So we're still looking to end up a little bit short.
And if the vaccine Hail Mary doesn't work, we'll just watch the continent burn down, apparently.

5) And the current unofficial official media/government downplay underway here in the US all goes away the minute there's another case here, either among those 100+ still under quarantine at home, or from Duncan v2.0, which a UK-published study estimates will be three export outbreaks per month, expecting two such in Africa and one in either the UK, France, or the US, every month forever until the outbreak ends.

What we have now is not calm of any sort; it's simply a breathing space for you to get your stuff together to deal with the next go-around. Make the most of the time.


Anonymous said...

I'm curious where lethality rate is 90% in the ongoing outbreak, as 70-ish percent has been typical so far.

(I know it was as high as 90%, or higher, is some of the earlier Congo outbreaks.)

A Texan said...

I agree that we are in a temporary calm period...we are now in the eye of a very weak hurricane, which is being followed by successively stronger ones.

I am not entirely sure that you are correct regarding the hoped for vaccinations. I think that the object is to develop a cadre of Ebola - immune healthcare workers in order to slow the spread somewhat. Any additional time gained will help. Of course there are a lot of ifs in there, while the Ebola keeps cranking along. You may well turn out to be right, especially if there is either a technical or governmental delay (and the latter is almost certain).

Anonymous said...

Ebola is endemic in Africa. We do not know what animal it is hiding in. The unknown animal(s) act as a reservoir for the virus.

What happens if Ebola finds an animal in the US or Europe or Asia that is a reservoir?

Does Ebola become the new normal? Endemic Ebola?

Anonymous said...

I do not find "the calm between the storms" to be any more realistically calming, than any of the other reasons to not be concerned, about any of the other... "challenges" we face. We are given pause to thoughtfully prepare as best we can for the cosmic bitch slap we are going to get - in more than one way - as the overdue comeuppance our multiple compound sins deserve begin to arrive with ever increasing severity and rapidity. To think we should avoid the wrath of God is the height of American arrogance. He does not want to apologize to Sodom and Gomorrah. We did not heed the warnings and listen when He whispered, we will surely hear it when He thunders. Use what time you have to prepare for whatever is coming, we won't escape it.

Aesop said...

@Anonymous 3:57
90% is the max observed Ebola lethality rate ever. WHO has consistently been counting those infected now in their death rate numbers, despite knowing it takes up to a month to kill someone after infection. That's Ponzi accounting. Even WHO has later finally acquiesced to noting a 70+% death rate, but they're still lying about that, and they know it.
Look at the numbers of infected +/- 3 weeks prior to the death rate now, for pretty much anywhere on this outbreak, and you'll see the numbers equal about 90%. (Knowing that getting reality from the official figures is like trying to nail down Jell-O.) I'd rather assume the worst, in any event and be mildly surprised, than paint a rosy picture, and get a severe shock the other way. Treated, we can apparently get it down to maybe 50%. Nothing happening in Africa equates to actual treatment. So anything there between 70-90% is the actual true death rate, and probably as close as anyone will ever know until a long time from now, if ever.

Even if they sent 100% Ebola-proof medical workers there, they would only save themselves. they are "saving" anyone in Africa, and the only thing they've accomplished in 10 months is to keep the doubling rate at 3- weeks, instead of allowing this to double every week or two. They only people they actually "save" are the 10% it doesn't kill outright, and would spare regardless even if they'd never opened up shop.

@Anon 12:35
This disease is no more God's wrath that landing on rocks is when you jump off a cliff. Thus it's nothing more nor less than the sum result of ongoing and compound egregious stupidity, apathy, ignorance, and hubris.
The stew would challenge any population's survival, and certainly doesn't require any special displeasure from one's deity to explain.