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.