Tuesday, November 4, 2014

Ebola Is Over


Our Ebola problem is solved, right?
Only one case left, and he's in treatment, and doing better.
(Yay, $10,000/day Western ICU medicine!)
So we have nothing further to worry about, right?
What could possibly go wrong?

Except that there's still only 5-8 of those 8-11 staffed BL4 isolation treatment beds (even though they have room for 23 patients, they have nobody to care for that many people, and you can't magically make those kinds of long-term experienced caregivers overnight).

And we're still importing any number of returning medical and volunteer workers from Ebolaville daily, along with 150 or so other potential disease-bearing souls every single day, with "screening" methods that would best be described as a total joke, on the level of posting signs banning Ebola, as if that would work.

(But hey, we do that for guns at schools and hospitals, and look how well that's working out!)

Oh, and lest we forget, those  10,000 13,500 40,000 actual Ebola cases, who annoyingly keep multiplying endlessly in larger and larger numbers, despite all available efforts currently employed worldwide to date for nearly a year.

So, just maybe it's over here, like earthquakes in Japan, California, and anywhere else seismic faults are active are ever "over": until the next time.

Which could be any one of the 3000 arrivals from West Arica in the last 21 days already here who may have, just like Duncan or Spencer, brought it here, but been totally asymptomatic when they arrived, and were "screened" by the Keystone Kops Clowncarnucopia Of Fail crack medical examiners of the TSA.

Any one of whom could be the next case, or engender the next cluster of cases, which will bring American medicine, and more importantly, government public health and biosafety experts a whole new and vastly more dangerous assortment of ways to utterly fail at their jobs and endanger the public's safety.

So just maybe, keep making prudent preparations for your future situation with that likelihood in mind.

Water and food that you set aside now isn't going anywhere for years, and there are plenty of other reasons you should have been socking it away anyhow: hurricanes, floods, tornadoes, earthquakes, financial collapse, power failures, or even simply the loss of your job in a crappy economy teetering towards another Great Depression, or worse. (And the under-acknowledged Great Recession of the last 6 years hasn't been any great picnic for a quarter of Americans either.)

The one thing we know is that there'll be another Duncan. There may be dozens. There will probably be a cluster or three. Current thinking even from the downplaying pollyannas of this problem is to expect clusters as large as 20 patients, and perhaps another 130 Ebola patients here in the short-term (say, a few months). After that, they cheerfully note, "it depends on what happens in West Africa." Which is, by all accounts, circling the drain in tighter and tighter circles, day after day. Our tiny troop contingent in the midst of it constructs the equivalent of 24 new treatment beds per day, while Ebola makes 300 newly infected people to put into them. So we're going to be a little short there by mid-December, when our troops will stop (and hopefully, be flown the hell out of there before they contract the disease).

Ebola, however, will just keep rolling along, racking up the infected and dead in great scything swaths, and eventually heading for the greener pastures of a continent of 1,000,000,000 people with exactly the same susceptibility to this pestilence as the petri dish it's been festering in for 11 months, and with no end anywhere in sight.

15 comments:

Anonymous said...

Coincidence maybe. Production started in May 2012. Heroin is a CDC researcher. Bad guys are evil Russians.

https://en.wikipedia.org/wiki/The_Last_Ship_(TV_series)

Feel free to delete if too tin foil.


J

Anonymous said...

Considering that Russians have already weaponized Marburg, and have had researchers croak in laboratory experiments with Ebola, it's hardly tinfoil at all.

Anonymous said...

https://en.wikipedia.org/wiki/Marburg_virus#Weaponization

Ex-Dissident said...

if you look at who and cdc reports over the last several days, they are all optimistic. Of course, this will change once the new round of numbers emerge. This could happen tomorrow.

Virginian said...

Today I read that two hospitals in Virginia have signed "voluntary" agreements with the government to take "possible" Ebola cases for testing and/or treatment. This is "in case" there are no available Ebola unit beds at the NIH, Emory, etc. The report did NOT say whether or not these Virginia hospitals have the required BSL-4 units to treat Ebola cases. Let's assume that neither hospital have BSL-4 units, instead opting for BSL-3 units. What dangers exist in using these lower-grade units for treating Ebola cases?

Anonymous said...

Liberia is looking better for now though. That is a positive development.

http://www.washingtonpost.com/world/africa/as-ebola-declines-in-liberia-health-officials-reassess-response-plans/2014/11/03/88126a4c-6365-11e4-bb14-4cfea1e742d5_story.html

From late September, when they were seeing 80-160 new cases per day, they are now seeing 20-30.

People were dying so quickly in September, there were literally bodies in the streets, but now that's no longer reported as being the case.

Could be that when people see enough of their friends and relatives die, they start to pay attention to preventative guidelines - which seem to be enough to keep people from getting the virus in large numbers, since it doesn't seem to spread easily (casually) until patients are very ill.

Thankfully, it looks like behavioral changes in the community may be sufficient to eventually stamp this thing out.

Aesop said...

Let's hope that the numbers Liberia reports accurately reflect reality, which flies in the face of all evidence since last April to date, not least of which their recent info-dump of 1600+ new cases less than 1 week ago.
They didn't suddenly figure out a way to make Ebola's mortality rate in their country drop from 72% to 37%, unless you also believe in the Easter Bunny and the Great Pumpkin.
Somewhere, they've been lying. It may be that they simply buried and cremated people so fast they didn't have time to tally them.

I hope the lull there is more than temporary, but based on their past behavior, I think Liberia has reached the point where nothing other than a complete absence of Ebola there is any grounds for optimism, and their numbers in the meantime are sheer fantasy.

So I'd be happy to find that WaPo isn't just playing the part of Baghdad Bob.

@Virginian:
The dangers are, everything that happened in THP-Dallas.

Ebola has been safely handled at treated as a BL4 pathogen.

Treating it as less than that, per CDC fantasies, immediately led to exponential growth, and a rapid rewriting of CDC recommendations, including the policy of moving all cases to BL4 isolation wards.
Bellevue hasn't done that with their one case - using the strict head-to-toe protection guidelines that were standard in Africa for a decade - but they've also lost the use of their ICU to any other patients. That won't be an option indefinitely, or in cities with less resources to draw upon.

Yojimbo said...

AESOP,

After the elections we have a better sense of how many possible Ebola cases are in the US. There was a powerful incentive to lie about possible and actual cases prior to the election.

Would you agree?

gamegetter II said...

Ohio still has one person under quarantine,and 51 others under some form of monitoring for Ebola-per the Ohio dept of health...

http://www.odh.ohio.gov/~/media/ODH/ASSETS/Files/ebola/Daily%20Contact/11-4-14/Daily%20Contact.ashx

Anonymous said...

I thought it was all better in Liberia now??

Anonymous said...

So much for the last refuge in Sierra Leone: http://www.ibtimes.com/new-ebola-outbreak-raises-fears-sierra-leone-1718900

It should be noted that tally graphs charting the course of the disease register no data from the area since Oct. 13: http://i100.independent.co.uk/article/last-district-in-sierra-leone-without-ebola-now-has-ebola--eJq7IklNUe

Anyway, "...On Tuesday, the Red Cross responded to the district's capital, Kabala, to collect the dead bodies of 30 suspected Ebola patients."

Aesop said...

@Yojimbo

While I don't doubt some people would like to lie about Ebola cases, I don't think anyone's willing to be the poster child for a lynch mob by getting caught at it.

I'm sure they're downplaying the chances for additional outbreaks, but I don't think anyone's actively covering known cases up. That would be an invitation to a criminal indictment in about a minute, assuming a mob didn't spontaneously assemble and burn you and your house to the ground long before the arrest warrant was even signed.

Percy said...

Virginian: Checking with someone who ought to know which VA hospitals these are and how they are equipped and being prepared for this eventuality, at least if they are in Northern VA. (One wold assume that the government is funding new BSL4 units in them if, as seems probable, they do not have them now, plus special training and so on for those who would have to deal with incoming patients.) If I get an answer, I'll follow up with another post.

Virginian said...

@Percy: Thank you so much for your reply. The two Virginia hospitals to potentially "treat" Ebola cases are: University of Virginia Hospital, Charlottesville: and VCU Hospital, Richmond. Cannot find any information about whether either or both of these hospitals have the required BSL-4 units, or if they are going to build them. Ditto, cannot find any information about the staff required to work in the units. Could be both hospitals are following the "gag order" relating to Ebola information relayed in the David Kroll article on forbes.com. General request for further information now urgent: anybody from these hospitals/local news media/citizen journalist, please help. Thank you.

Percy said...

Virginian: And thank you for your update. My guy is Northern VA and so is unlikely to be following what's going on in Richmond and Charlottesville. But he may well be able to inquire and learn about the two big unknowns. He's slow in answering his email these days, but I will follow up my earlier inquiry to him with this information and ask him to ask. News will be reported here if received.