Tuesday, November 4, 2014

Liberia: Not So Fast



The WaPo is cheerfully reporting that Ebola is on the decline in Liberia.
The rate of new Ebola infections here has declined so sharply in recent weeks that even some of the busiest treatment facilities are now only half-full and officials are reassessing the scale of the response needed to quell the epidemic.The turnaround has occurred without the provision of a single treatment bed by the U.S. military, which has promised to build 17 Ebola facilities containing 100 beds each across Liberia. Those treatment units will be constructed, said Bill Berger, head of the U.S. Agency for International Development’s Disaster Assistance Response Team here. But the option of initially opening some with as few as 10 beds is “being discussed,” he said.

So evidently the beds that aren't nearly enough, are now supposedly totally unnecessary, leading yet again to wonder WTF we have troops there at all. Somebody at the Post needs to get their story straight.

The leader of Liberia is not quite saying any of that:
Monrovia — President Ellen Johnson-Sirleaf has cautioned Liberians not to be too happy over the decline in the number of Ebola related cases in Liberia. The Liberian chief executive wants citizens manage their emotions as the fight against the killer disease intensifies.
More than 2,500 persons have died of the deadly Ebola Virus Disease (EVD) in Liberia in March 2014, according to the World Health Organization (WHO).
Recently, the WHO reported that the Ebola virus in Liberia is declining.
According to President Johnson-Sirleaf, Liberia has "reached a place where there's a reduction in the number of people going into treatment centers."
So there could be fewer people actually sick, or there could just be greater unwillingness to go to the death house and wait for the arrival of the Grim Reaper.

Which is not at all the same thing as Ebola being "on the decline."
Just that their ability to count cases and deaths, which has never been particularly confidence-inspiring anywhere at anytime, may have completely lost track of this outbreak.

Neither the UN nor Doctors Without Borders are having any parties:
It's too early to say the Ebola outbreak in West Africa is waning even as reports of empty beds in treatment centers and a decline in the rate of new cases in some areas buoy optimism, a United Nations envoy said.
Transmission has slowed in parts of Liberia and Sierra Leone, though the virus is “advancing rapidly” in other areas, said David Nabarro, the senior UN system coordinator for Ebola. Infections have flared in communities where there had been improvement.
“It’s hard to tell exactly where we are at the moment -- whether we have started to turn the corner or not,” Nabarro said in a telephone interview today from Geneva. “Once the curve starts to come down, we worry like mad that people will take their eye off the ball and it starts to go up again.”
Nabarro joins other health officials in urging continued vigilance.
Stringent control measures, including safe burial practices and rigorous “contact tracing” of people who may have been exposed to the virus, have helped lower transmission rates in areas such as Lofa county in the north of Liberia, on the border with Sierra Leone and Guinea, Nabarro said.
“Maintaining the effort until the very last case is identified and brought under treatment” is critical, he said. “There is always a tendency for people to get excited for a period of time and then move onto something else.”
Koinadugu district in northeastern Sierra Leone recently had its first cases of Ebola, showing the outbreak is still spreading, the WHO said last week.
Doctors Without Borders, which has more than 250 international staff in the three worst-hit countries and is operating six treatment centers, said last week it is seeing “critical gaps in all aspects of the response.”
Save the balloons.

Meanwhile, Sierra Leone is quietly going to hell in a handbasket:
DAKAR, Senegal (AP) — Thousands of people in Sierra Leone are being forced to violate Ebola quarantines to find food because deliveries are not reaching them, aid agencies said.
Large swaths of the West African country have been sealed off to prevent the spread of Ebola, and within those areas many people have been ordered to stay in their homes.
In an address to political leaders in Sierra Leone, President Ernest Bai Koroma said ordinary people also have to do more. He defended the stringent measures he has imposed and called on all citizens to stop dangerous behavior that has fueled Ebola's spread, such as secret burials where corpses are washed or even people touching the sick.
"We have to take the sick out and take the responsibility with firmness," he said. "We must end Ebola now."
While public health authorities have said heavy restrictions may be necessary to bring under control an Ebola outbreak unlike any other, the Disasters Emergency Committee, an umbrella organization for aid organizations, warned on Monday that they were cutting off food to thousands of people.
"The quarantine of Kenema, the third largest town in Sierra Leone, is having a devastating impact on trade — travel is restricted so trucks carrying food cannot freely drive around," the committee said in a statement. "Food is becoming scarce, which has led to prices increasing beyond the reach of ordinary people."
Because services are not reaching them, people who are being monitored for signs of Ebola — and should be staying at home — are venturing out to markets to look for food, potentially contaminating many others.
Also, nota bene that the AP is covering the story on Sierra Leone from two countries away, and literally "phoning it in"; most stories on the current state of things are being reported after telephone calls from outside, to those inside. Pardon my skepticism on the media's ability to get this right from 500 or 1000 miles away, by remote control. They do poorly enough standing right on the spot.

21 comments:

gamegetter II said...

Going by some of the reports about Sierra Leone-
if there are people who should be in their homes because they have had contact with a person who had Ebola and they are out and about,buying food and supplies in the markets-then we will probably see another big jump in the number of cases.

Yes?
No?
Maybe?

Aesop said...

It's already happening.
That's one reason why Ebola remains totally out of control in SL.

Ex-Dissident said...

Liberian numbers are completely screwed. They likely have had over 10,000 cases, and maybe over 20,000 already.

Anonymous said...

I commented a few days ago about the numbers will start to oscillate.

Maybe I am reading the tea leaves too closely, but this could be the first.

Reliable numbers are scarce, and the only certainty is that it is spreading like wildfire.

I seriously doubt the claim that Nigeria is Ebola free. The cant stop boko haram, how can they stop this?

Looking at the map, we have heard nothing about Ghana Togo and Benin in the news. Maybe a perusal of the local news websites in those countries? Nigerias closest border in the direction of Liberia is north west. Right in Boko Haram area.

Percy said...

Ebola, of course, is bad for business where it is prevalent. That chokes off the money. Not good for politicians to oversee choking off the money. I leave what to think about how this affects reported numbers to your imagination.

As to beds we're building over there, I make the same point, except in this case it's the beneficiaries of government contracts to get everything over there and do stuff related to the building. (Didn't Obama ask for something like $500 million for this? Where does that money go -- to whom? Does it have anything to do with stemming Ebola?)

So, of course, even if it is so that the numbers actually are dropping and the drop, if real, is a true trend, we're going to build the stuff or figure out some other way of paying those involved what was promised, regardless.

Root of all evil, they say. True enough as far as that goes. Lots of evil to go around for other reasons, too, though.

Anonymous said...

Good morning Aesop,

WRT the purported agreement by the big news distributors to not run ebola stories until infection is confirmed.

Local news in North Carolina is running a story "ALAMANCE COUNTY, NC (WTVD) --
Alamance County Health Department officials say they are monitoring five people who recently traveled to Sierra Leone, Liberia or Guinea. "

But google show NO mentions on any other national news...

One instance doesn't make it true, but it does seem more likely. The UK Daily Mail Online currently has NO ebola stories on the front page, and they've been leading the pack with coverage in the past.

Anyone else have LOCAL ebola coverage that isn't being reported by the larger outlets?

nick

Virginian said...

@Anonymous, thank you for the heads-up about the situation in Alamance County. Sounds to me like more of the "gag order" by the media on Ebola cases described by David Kroll in his forbes.com article of 11/2 (and updated). Question: if, God forbid, any of the people being monitored in Alamance County comes up with a positive RNA test for Ebola---which media will report it? What happened to the First Amendment in this situation?

sacredappleseed said...

This article wwwDOTredflagnewsDOTcom/headlines/breaking-ebola-nurse-boyfriend-reportedly-symptomatic-hospitalizedsays ebola nurse (nina) boyfriend is showing enough "flu" symptoms to be hospitalized...

So I will not be too surprised when mimi's boyfriend is "surprised" with a "flu" fever soon enough.

Virginian said...

So now there's a linked story to USA Today from DrudgeReport tonight that Obama is using the U.S. Health Service---70 of their personnel---to actively treat Ebola cases in Liberia. Which means, of course, putting every one of them directly in danger of getting the disease. Anybody with further corroboration? Also---what about the over 300 potential Ebola cases being monitored right now in New York City?

Grouch, MD said...

The CDC has asked this low risk exposures not be mentioned in the media. There are also privacy laws that apply. We are following about 5 in this town of about 150,000 people.

gamegetter II said...

Aesop/Doc Grouch-

Have you read this one...



"The number of people who are being actively monitored for Ebola in New York has tripled to 357 people, none of whom has displayed any symptoms, city health officials announced Wednesday.

The vast majority of those being monitored arrived in New York in the last 21 days from West Africa, the New York City Health and Hospitals Corporation said in a statement. Those under monitoring are being checked out of “an abundance of caution,” the statement said.
Related story: Disorder among states' Ebola strategies raises worries
Related story: Disorder among states' Ebola strategies raises worries
Tina Susman, Melissa Healy

The latest announcement comes as Ohio said it was officially Ebola-free and Texas prepared to end its observation period for the last 27 healthcare workers. The Texas group will complete its 21-day monitoring period on Friday, according to state officials.

The Ohio Department of Health reported that the state had officially moved to “triple-zero” status: no confirmed cases of Ebola, no people under quarantine, and no contacts with any possible Ebola patients."

http://www.latimes.com/nation/nationnow/la-na-nn-ohio-ebola-free-monitoring-20141105-story.html

gamegetter II said...

One more-

The Cleveland Clinic told their nurses-as of today-to use the same
PPE as they would for influenza or C. diff.
Also that they were training a special team to handle Ebola patients.
TPTB at the Clinic failed to explain what the nurses are supposed to do before the "special" team arrives,other than the above about PPE.

This is not rumor-it's from a family member who's an RN at the Cleveland Clinic.

The family member is pissed off-as are 99.9% of the nurses,who I can pretty much guarantee are going to walk out if they get an Ebola case.

geoffb said...

First I'd like to thank you for all the work you have done on Ebola.

There was this piece I read that has some good info and some of the usual in it.

http://arstechnica.com/science/2014/11/understanding-the-ebola-virus/1/

From that here are links to the proteins that Ebola has encoded in it. I hope this is useful and not a replication of info already posted here.

http://www.uniprot.org/uniprot/?query=Zaire+ebolavirus+%28strain+Mayinga-76%29+%28ZEBOV%29+%28Zaire+Ebola+virus%29&sort=score

Anonymous said...

Philippines is quarantining their UN peacekeeper recalled from Liberia on a small island SE of Corregidor you can view it on google maps.

They have recalled ALL OFW workers from Liberia and Sierra Leone. They are in quarrantine in Africa.

Wild rumors started today about a outbreak in Taytay Philippines which is a suburb or Manila. The rumors are FALSE.

Anonymous said...

Hey Aesop.

Where did you go?

No new posts for over 24 hours??

Anonymous said...

Maybe he's working, or maybe he depressed himself.. this is all not happy news.

Well Aesop, I can help put it into more cheerful perspective! ;)

Think another Carrington Event - you get something like a CME (Coronal Mass Ejection) that's off the scale, like a G5 or larger geomagnetic storm. Because that's never happened before, so nobody's given a thought to, I don't know, hardening the grid or anything. Ok, well the power would be out and a lot of people could handle that (well the Amish would certainly survive at any rate), but they figure a grid down scenario would go on for at least 18 months during which a LOT of people would die. A LOT.

The fun thing is, you have all of these nuclear power plants everywhere with exactly what, 8 days of diesel backup to cool their cores? Once that goes, they start to melt down. Figure the CME only hits one side of the planet, so only 200 or so power plants are affected this way. That's 200 Chernobyls. Yeah, nobody without a hell of a bunker is going to make it through THAT.

So hey! At least with Ebola there's quarantine and isolation, right? There we go, things are looking up already! :)

A Texan said...

FYI: http://www.ephysiologix.com/ebola-separating-fact-from-fiction/

Thoughts, anyone?

TFA303 said...

The number of people under "active monitoring" for Ebola symptoms has increased from 117 on Monday to 357 people Wednesday, health officials said.

The vast majority of those being monitored arrived in New York City within the past 21 days from the three Ebola-affected countries, the New York City Health and Hospitals Corporation said in a statement.

http://www.nbcnewyork.com/news/local/active-monitoring-ebola-doctor-Craig-Spencer-bellevue-hospital-281671121.html

Anonymous said...

http://news.vice.com/article/the-ebola-outbreak-is-getting-worse-in-sierra-leone


Gee Prez, only $6 billion?

Percy said...

Anonymous re Philippines: Thanks for this. Have an aging relative (90) headed there (Cebu) for a few weeks. Knew those UN helpers had been recalled and assumed a quarantine, since the Philippine government seems determined to keep this thing away from the people. Good to know there is one -- and that rumors about an Ebola outbreak there are false. Lots of other concerns there,to, of course.

Anonymous said...

From WHO ... for your consideration Raconteur:

'Thousands' of Ebola deaths likely unreported: WHO expert...

https://uk.news.yahoo.com/ebola-toll-too-low-thousands-bodies-likely-missing-173104066.html#Nca46Tp


regards and tks

S