Wednesday, October 22, 2014

Maybe Never, Maybe Already, Maybe Tomorrow: Ebola and Cote d'Ivoire

Here's a little taste of Before It's News for you:

Cote d'Ivoire (former Ivory Coast) is the nation to the immediate east of Liberia.
It also borders Guinea. In size it's slightly larger than New Mexico.
The population is over 24M people, or more than the combined total of the three currently Ebola-affected countries. The average life expectancy is 58, infant mortality is huge (202nd out of 224 countries worldwide), and a quarter of the population lives on less than US$1.25/day. 38% of the population is less than 15. There are only about 3300 doctors for the entire country, about 1 per 7000 people. (The US is at about 1 per 400 for comparison.)
The literacy rate (57%) makes the worst county in Appalachia look like Harvard or Oxford.

Following a disputed 2011 presidential election, the winner was installed by French and UN peacekeeping forces, but the rebels hold the northern half of the country, with government forces holding the south. The former capital is Abidjan, on the east central coast, with 3.3M people; the official capital is Yamoussoukro, inland. C.I. is the largest exporter of cocoa beans in the world, which is a big deal if you make anything chocolate, like Swiss multinational Nestle, the largest food company in the world (including sub-brands Stoufer's, Libby's, and Gerber) with US$90B in sales annually, of which 11% is chocolate/candy/etc. Also greatly affected would be Kraft, Mars, and Hershey.

Ivory Coast has a military of less than 10,000 troops, about 2/3rds conscripts, and a national police force about half that size.

Things to note:
Liberian troops during internal quarantines were regularly bribed to allow people to come and go from quarantine areas daily.
Despite flight bans and border closures, people can readily cross from countries in either direction.
And government border closures are only enforced in the southern half of the country where it has control. What happens in rebel-held areas is anyone's guess.

Ivory Coast tops a list of 13 countries the World Health Organization is urging to be prepared for cases of the Ebola virus to ensure the epidemic doesn’t spread further.
The virus has spread to five of the seven counties in Guinea and Liberia that share borders with Ivory Coast, compared with just one county five weeks ago, according to the Geneva-based WHO.
“We are extremely at risk given the fact we share borders with two countries heavily affected,” said Daouda Coulibaly, head of the epidemiological monitoring service at the Ivory Coast’s National Institute of Public Health. “Considering the trade and the movements of population, we are extremely exposed.
The nation’s government in August suspended flights to and from the three affected countries and closed its borders with Liberia and Guinea in an effort to keep Ebola out.
The WHO’s checklist will ask the 13 countries to ensure they have laboratories that are able to test for Ebola, enough protective equipment and staff to perform contact tracing. The countries will need to develop protocols for handling medical waste, a communications plan and other measures to ensure they’re able to rapidly contain the virus, the WHO’s Bailey said.
Several isolation centers have been established in the largest city, Abidjan, and the country’s west that will be converted into as many as 20 treatment centers in the next few weeks, Coulibaly said. The government has also sent mobile phone text messages to citizens, banned the sale and consumption of bushmeat and advised people to abandon shaking hands and the traditional three-kiss greeting.
More telephone lines will be set up to provide information about Ebola after the first ones were overwhelmed with calls, Coulibaly said. The government installed hand-washing equipment at the entrance to public buildings.
Alassane Sogodogo, a cocoa farmer in the town of Para, a small town about 20 kilometers (12 miles) from the border with Liberia, said closing the border has helped limit the number of people crossing over.  
People still cross the border on bush tracks and residents are “a bit worried but less than they used to be.”
“At least they’re not selling bushmeat any more,” Sogodogo said by phone yesterday. “There is no Ebola in the village on the other side of the border, so we don’t believe Ebola will arrive here.
People in Para are being more careful and are washing their hands more often, he said. Still, hand sanitizer is too expensive for many people, he said.
There’s little serious concern in Abidjan, a coastal city of about 6 million people on the Gulf of Guinea. Morgane Habiyaremye, the owner of a trendy bar in the middle-class neighborhood of Cocody, said her compatriots are aware of the precautions they need to take, and have stopped shaking hands. She’s installed a bottle of hand sanitizer on the bar.“I’m surprised it hasn’t reached Ivory Coast yet,” Habiyaremye said. “With the migration flow in the region and the fact the borders are porous, I don’t see how Ebola is not going to spread into the country at some point.”
Benoit Dikpe, a 42-year-old tailor in Cocody, said he’s stopped shaking hands except at home and with his three employees.
“I’m worried Ebola reaches Abidjan, but the government has taken protective measures to prevent people from these countries to come in,” he said. “So I don’t really think it will happen.”
While Ivory Coast may not be able to keep Ebola out, it can be ready to stop it from spreading widely, Coulibaly said.
“The objective is not so much to prevent the disease,” he said. “It can come, but we need to detect at an early stage and contain it.”

So even their medical expert recognizes that Ebola is going to cross their border, they aren't much better prepared in real terms than any of the three countries that have it now, and when, not if, it gets there, it'll not only devastate the people, but also play havoc with food prices for the world, because giant corporations aren't going to eat losses, they're going to raise prices in general to protect their stockholders, because that's how they roll.

And despite throwing everything we have into Guinea, Liberia, and Sierra Leone, we haven't stopped Ebola, nor even so much as slowed it down it the slightest. Thus when it gets to Ivory Coast, there'll be nothing extra left to send.

Now you know more about this than President Obola will, because you read this instead of skipping the briefing, taking a nap, or going golfing.


A Texan said...

"More telephone lines will be set up to provide information about Ebola after the first ones were overwhelmed with calls, Coulibaly said."

So they KNOW it is coming.

Ho. Lee. Schit.

I'm glad that they are taking some precautions, but how much good will not shaking hands (except at home, or with employees, because none of them can pass Ebola to you) do when people wearing hazmat suits get it? Not much, if anything, I'm afraid.

Yeah, we're in the lull before the storm. Patient 2.0 ought to be here sometime in the next couple of weeks. Maybe I'm selfish or cynical or something, but I find it difficult to appreciate Obola's need for us to share in this, uh, experience. STOP THE FLIGHTS FROM WEST AFRICA!

Anonymous said...

As I once again risk redundancy...
No one should be allowed to leave the 'host' countries without a 60 day monitored quarantine. Not by aircraft, boat, car, truck, foot, hang glider, scooter... NO ONE, NO HOW, NO WAY. This contagion must be contained, and the definition of "contained" is: don't let it out because otherwise... (risking redundancy yet again) the option becomes... napalm. 
We may be fortunate and blessed at some future time for placing blame, making correct assessments regarding the lack of leadership, etc. Right now, that is a big 'if'. What we NEED immediately is the strength of will to make the hard decisions necessary to protect the uninfected people and places on the planet. If the sacrifice of the few to save the many is required... for God's sake, people, someone needs to step up to the plate.
I do apologize, but it is late - in more ways than one. Grandpa is usually averse to redundancy, but what is important does at times bear repeating.

Anonymous said...

I'm not as panicked as some. Granted, the CDC has proved itself totally untrustworthy when on one hand they advise personal protective clothing to include N95 masks at minimum, ideally helmets with positive pressure ventilation, on the one hand, and then on the other say that the bugs aren't airborne.

On the other hand, never underestimate the ability of large swathes of public to panic if a significant US outbreak were to occur. And in that case, I'd bet my last dollar that people would not be so stupid as to ride public transportation and congregate in large groups as if nothing is happening. And if the embers spontaneously separate themselves, the fire will die out, not by government, but as it were by an invisible hand a la Adam Smith. And likewise, our concern for #1 will work toward all our mutual benefit.

Of course, I'm rural, and you city suckers make great canaries.
Bill K.