Monday, December 8, 2014

WHO Admits They Were Talking Out Their


LONDON (AP) — As health officials struggle to contain the world’s biggest-ever Ebola outbreak, their efforts are being complicated by another problem: bad data.
Having accurate numbers about an outbreak is essential not only to provide a realistic picture of the epidemic, but to determine effective control strategies. Dr. Bruce Aylward, who is leading the World Health Organization’s Ebola response, said it’s crucial to track every single Ebola patient in West Africa to stop the outbreak and that serious gaps remain in their data.
“As we move into the stage of hunting down the virus instead of just slowing the exponential growth, having good data is going to be at the heart of this,” Aylward said. “We are not there yet and this is something we definitely need to fix.”
“Decisions about prevention and treatment should be data-driven, but we really don’t have the data,” agreed Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.
A week ago, the World Health Organization insisted at a media briefing it had mostly met targets to isolate 70 percent of Ebola patients and bury 70 percent of victims safely in Guinea, Liberia and Sierra Leone. But two days later, WHO backtracked and said that data inconsistencies meant they really didn’t know how many patients were being isolated. Then the U.N. health agency also conceded that many of the safe burials were of people not actually killed by Ebola.
Aylward said not knowing exactly how many Ebola patients there are in hotspots like western Sierra Leone means health officials might miss potential contacts who could unknowingly cause a surge of cases. Compared to other epidemics like malaria, which is more seasonal and can fade away without huge control efforts, ending the Ebola outbreak will require extraordinary attention to detail.
“This outbreak started with one case and it will end with one case,” Aylward said. “If we can’t get 100 percent of the contacts of cases, we will not be on track to shut it down. Unfortunately at the moment, the data right now is not enough for us to get to zero.”
In West Africa, where health systems were already broken before Ebola struck, collecting data amid a raging outbreak has been challenging. 
 IOW, any resemblance between the press releases WHO has been shoveling out, and reality, is purely coincidental and entirely unintentional.
Notably, they waited until after their celebratory "We hit all our goals" party to announce they were completely full of it, and have been since about last April.

18 comments:

geoffb said...

I fully expect that after the Dec. 16th? election Liberia will suddenly find a large number of "new" cases and deaths.

But it will be quite awhile, if ever, that the actual numbers will become known.

mike18xx said...

Pursuant to previous topic, Aesop wrote: "The biggest issue there is finding people literate enough to train in order to operate the facility. -- This is why the Kerry Town Ebola facility the UK built in Sierra Leone is only operating at 25% of capacity: they can't find 100 locals smart enough to train to do the jobs."

Compounding this problem is that the literates there are at the upper end of the bell-curve distribution of intelligence, meaning the Brits need to attract the people with the least financial incentive to join, and the most brains to weigh the risk negatively.

And this, mind all, in a nation where English is the national language (as it also is in Liberia next door) -- that's the *best* it gets over there. If Ebola gets into the Ivory Coast, then we may assume that MSF has already enlisted every last capable French-literate person they can, and they're already swamped.

mike18xx said...

Also, concerning RushBaby's comment, I would expect a logarithmic or even geometric flattening of new confirmed cases to manifest simply due to there being a finite limit to the amount of driving, collecting, testing, tabulating and reporting that a finite number of facility personnel are able to accomplish.

I would speculate that we have already reached that finite limit. E.g., numbers hovering under 100 cases/day in Sierra Leone for several weeks despite no obvious good news of any type in that country.

Anonymous said...

The scary part for me is seeing this slow motion disaster in real time. It looks like an avalanche slowed down to 1/1,000,000 speed. I started reading Aesop's blog when there were <1000 deaths total. Now it is ~100 dead / day.

I am reading John Barry's "The Great Influenza" and if Ebola spread even remotely like the Spanish Flu, West Africa would have been depopulated months ago. Thank God Ebola incubates slowly, and it is not airborne. Woodrow Wilson, the first Progressive Democrat President and Obama (hopefully the last Progressive), are reacting similarly, deny, underestimate, and convince the press to lie for you. Wilson had his war-time anti-sedition laws to "patriotically" muzzle the press and spread Allied propaganda. Our modern press is willing to ignore stories and peddle Obama's lies for no reason except partisan advantage.

mike18xx said...

Since (1) the western press is these days the mouthpiece of Fabian socialism, and (2) Google is also doing its part to filter the news of all English-language content, I've been using Google's auto-translate feature to target French-language articles from Ivory Coast.

Find of interest:

Guy pukes up a blood and dies in Bouake on Dec. 5. (No word since.)

Second source. (Could just be a old guy croaking of malaria, but who knows.)

Some general background on the Ivory Coast border region (read last few paragraphs of the piece).

Ex-Dissident said...

Mike,
I also suspect that there are cases in Ivory Coast. It has a long border with Liberia, and since Liberia is suspected of harboring the largest number of Ebola infected people it makes sense that some will travel over that border. There is also plenty of Malaria in that country and my facility has treated people from the Ivory Coast with Malaria within the past 6 months. That was scary for us since the symptoms are very similar and initially we didn't know what was causing the symptoms. At this time, I am not sure that I would feel comfortable caring for a sick man from the Ivory Coast even after his blood shows malarial parasites. At this time, I think I will still insist on him being ruled out for Ebola. I also must admit that it is surprising that are not seeing an uptick of Ebola cases coming to the US or other parts of the world.

G-man said...

The hiatus in cases cropping up here is most likely due to the following:

1. Media collusion. I guarandamntee there are individuals getting off planes with symptoms, and who end up getting tested (and subsequently end up negative). The MSM is not reporting the number of suspected / monitored cases since they "Don't want to cause a frenzy" and more importantly "Don't want to be out of line with the official position that not having quarantines is a Good Idea™". Anyone heard anything re: the serviceman who got sick on a flight home from there? Did he test clean? [crickets...]

2. Anyone with a brain can see that remaining over there is a bad idea, and anyone with the means to effect such has already un-assed the AO. Any politician who's saying some version "We've got this under control" either has significant cognitive deficits, or is a lying sack of sh*t vying to be king of Ebolaville when everything collapses. It's Africa, there are not 'Patriots' trying to right the sinking ship just because.

3. Blind damn luck.

mike18xx said...

Ex-Dissident, where are you situated?

Aesop said...

@mike18xx-

I suspect you're correct:
the total number of cases per day is not a function of actual cases, it's a function of the maximum capacity to test cases, and has been for some time.

To exactly the same extent that the declining death numbers are a function solely of the number of people reporting to the Ebola No-Treatment Centers, and those are the only ones actually tested and counted, hence their inclusion in official statistics.

Everyone infected outside, and not helpfully residing in an ETU when they die, thus never tested, is treated like they never existed.

Which in a couple of weeks is exactly what happens.

Which explains the numbers both official and actual, the gap between same, and the ongoing spread of the disease with precisely zero extra muss and fuss necessary.

QED

Well done, sir.

RushBaby said...

Like others here, my biggest frustration is media censorship and self-censorship.

There are important things out there that should be picked up by the big outlets and spread.

Such as this study, http://www.sciencemag.org/content/345/6202/1369.abstract, in which it was found that the current ebola genome already contains 300 mutations. The consequences of this are unknown, but the implication is ominous. Considering that the influenza virus mutates so rapidly that researchers must formulate a new vaccine every year, the ebola virus has the Potential to out-mutate attempts to create an effective vaccine -- not to mention the problems with vaccine production and distribution that Aesop has already pointed out. Incidentally, several of the authors of this study, veterans and experts in the science of ebola, are dead now (of ebola).

Where is the amplification in the press of stories such as:

• Monrovia, a coastal capital, gave up on attempts to quarantine infected ghettos. People were simply swimming out.

• Samples heading to labs have been lost due to attacks on the roads.

• Burial teams have been attacked and stoned in some cases.

• Inheritance rituals are, in addition to body washing, implicated in the spread of the virus, because they take place at the funeral. Funerals are important not just to mark the passing of the deceased but also as part of the process of “unmaking” a marriage at death, so that families can publicly reassert their land rights. Here is a dry, but fascinating academic paper on this subject, among others:

http://blogs.plos.org/speakingofmedicine/2014/10/31/social-pathways-ebola-virus-disease-rural-sierra-leone-implications-containment/

There is grist for the media mill here. After all, if it bleeds, it leads…right? Who wants to suppress these "optics" and why?

Thanks again to Aesop and others here for curating some news, information, and analysis. I want to be informed, not pacified.

RushBaby said...

uh oh, did I offend in some way? My last comment is gone...

I will be happy to furnish my email address.

Aesop said...

I have deleted no comments.

RushBaby said...

Thanks for responding, and...rats. I did a lot of work on that comment! There were a couple of long-form links in it. Perhaps your blog software interpreted it as spam.

Ex-Dissident said...

Mike,
NYC.

I had a chat with one of my hospital administrators today and asked her what she thought of Spencer being treated as a hero. I got back an indignant - He is absolutely a hero, to go there and treat such a disease, and besides he wasn't really infectious when here.....

Ahh OK. Got my answer and won't ask any more questions.

Sir DH Slammer said...

The thing I appreciate most about intelligent internet discussion is having a free flow of conflicting thoughtful ideas and not being shouted down with echo chamber groupthink.

I maintain that this whole Ebola thing is still a hoax designed to drive the Chiners out of Africa and secure resources, mostly oil. Any 'relief' money will be summarily funneled to next years African version of ISIS who will be fighting for regime change against any African govts that wont play ball.

There are still no verifiable facts that would prove otherwise.

Aesop said...

Well, except for all those dead bodies laying around.

Got any hypotheses that fit the actual facts on the ground?

Anonymous said...

Well, yeah, the bodies are a problem... Sir DH, given the gov predilection for lack of truth, I see where you are going. What is even sadder, is that the reasoning IS to keep China out of Africa, but gov will actually infect locals to make it happen... Grandpa says please do not trust the gov, he will guaranfuckingtee they are up to no good. Hence the lack of news, facts, and planning.

Anonymous said...

..........Nice..^_^v............