Tuesday, October 28, 2014

Titanic sinking; Captain concerned.

If only I'd said this already. Oh, wait, I did say all this yesterday. So we've established that the AP and UN are only about a day behind me. Guess I'm slipping.
KAMPALA, Uganda (AP) — Authorities are having trouble figuring out how many more people are getting Ebola in Liberia and Sierra Leone and where the hot spots are in those countries, harming efforts to get control of the raging, deadly outbreak, said  Anthony Banbury, the U.N.'s top Ebola official in West Africa said Tuesday. "The challenge is good information, because information helps tell us where the disease is, how it's spreading and where we need to target our resources," Banbury said by phone from the Ghanaian capital of Accra, where the U.N. Mission for Ebola Emergency Response, or UNMEER, is based. Health experts say the key to stopping Ebola is breaking the chain of transmission by tracing and isolating those who have had contact with Ebola patients or victims. Health care workers can't do that if they don't know where new cases are emerging.  
The president of the World Bank, Jim Yong Kim, meanwhile, said the three countries need at least 5,000 more health workers to effectively fight the epidemic. Kim said Tuesday that he is worried about where those health workers can be found given the widespread fear of Ebola. Quarantining health workers returning to their home countries could also hurt recruitment efforts.  
The U.N.'s target is to have 70 percent of Ebola cases getting access to a treatment center and to achieve a similar percentage for safe Ebola burials. "They are extremely ambitious (goals), given the geographical spread of the disease, the numbers of people infected, the very poor information on exactly where those infected are and what the transmission patterns are," Banbury said. "The three things we need the most are people, supplies and money. The most critical right now are people, health workers in particular, trained health care workers . But also people who can manage these Ebola treatment facilities." Ban said the transmission of the virus continues to outpace the international community's response. He appealed to the AU's 54 member states not to impose Ebola-related travel restrictions or close their borders. Some already have. Dlamini-Zuma said African Union states have pledged to send more than 2,000 health care workers to West Africa. She did not say when the workers would arrive.
So everything I said yesterday is spot-on.
The only thing missing to get ahead of this is people, supplies, and money:
  which is, in short, EVERYTHING.
It's like trying to make a hamburger without meat, condiments, and a bun.
They need 5000 more health workers, when articles BACK IN SEPTEMBER quoted UN officials as having trouble coming up with so many as 10.
And the other countries in the region have pledged more health workers than the total number they probably even have.
Promises are cheap, and in this outbreak, as cheap as Zimbabwean dollars.


Tucanae Services said...

Question is, behind closed doors, are discussions going on about possible conscription of medical personnel? To a certain extent it has already occurred via obama and his shipping 3000 DoD types to The Zone.

Anonymous said...


The executive order activated the Individual Ready Reserve, for people with "needed skills."

That could easily translate into anyone ex-military with ANY medical training, but probably initially limited to anyone with NBC and medical or medical management skills.

So you have a de facto compulsory service already.


Icepick said...

Has anyone heard of the surviving medicos being recruited for Ebola response teams in the US? From what I've read they believe that such people will be immune to future Ebola infection from that particular strain. They would still be subject to the usual safety protocols, but would be at less risk of infection when the inevitable screw-ups occur.

Sorry if this has been covered before, but I haven't seen it.

So, what obvious problems am I missing, besides getting the people to do the work?

Jamie NZ said...

Scene from Platoon...

{Chaos and confusion reigns, fear panic and death is near, the fog of war}

Sgt. Barnes: [To CDC/Barack Hussein Obama]

You ignorant asshole!!!
What the fuck coordinates you giving???
You wasted a lot of people up there with your fucked-up pandemic response!!!

You know that???
You know that???

....Ah, shit!!!



Sgt. Barnes: Y'all take a good look at this lump of shit. Remember what it looks like.
You fuck up in a pandemic and I goddamn guarantee you a trip out of the bush in a body bag!!!
Out here, assholes, you keep your shit wired tight at all times!!!

[To 'the keep calm crowd']

Sgt. Barnes: And that goes for you, shit-for-brains. You don't run your mouth on no fucking ebola-pandemic!!!

[To CDC/US Govt]

Sgt. Barnes: And the next son of a bitch I catch copping "Z"s in the bush, I'm personally gonna take an interest in seeing him suffer.

I shit you not....

Raconter, tag em and bag em

Anonymous said...


Google the quotes from the survivors. The meme (especially the NBC cameraman) is that THERE IS NO MORE VIRUS PRESENT IN THEIR BLOOD. This means you cant prove they ever had Ebola, and that they arent necessarily building up an immunity. Strange that...

Ex-Dissident said...


I just figured out why I felt a certain coldness at your site during the past week. Back in February I made a quick comment about wound care and that inspired a lengthy post on your site; a very angry post ridiculing me. OK, obviously I misunderstood some of the things you planned to accomplish in this course, but you should lighten up over misspellings and typos. Anyway, your posts on Ebola are excellent and keep it up.

BTW, sterile water for wound cleaning is not that hard to come by: just add salt and boil it for 20 minutes.

Ex-Dissident said...

To Tucanae,

It certainly can happen. I heard a story about how a full class of students were conscripted to work at Chernobyl. They were handed clothes and taken to the train station. One of them apparently jumped off the train and ran away, throwing his whole career down the drain. The rest went on and all died.

If there is conscription of medical personnel, it will probably first hit the ones least able to resist - students and residents. If this monster grows large enough, it will get to everyone.

Anonymous said...

I read the above, twice. Then went back and re-read what you have been posting FOR WEEKS.
I will now offer yet again a condensed version for the intellectually challenged, or those who need the time to PREP as best they can. 1) ebola 2) non-stop 3) very virulent, no certainty in root transmission, and medpros cannot keep pace, no how no way. 4) pandemic 5) best case: 50% die, realistically 70% or more mortality 6) great snapping arseholes... 7) napalm
All while the rest are whistling past the graveyard. Appropos, Hallow'een season. Good luck to all of us in making the Marine Corps Birthday, let alone Thanksgiving or Christmas.
Plan on spending New Year's Eve at home. If we get there...

Aesop said...

I apologize and revise my earlier remarks.
We both misjudged each other.

Grouch, MD said...

You check for prior infection using antibody levels.

Aesop said...

In W. Africa those who survive assist with the care of those still in the throes of the disease, because they're already infected, so they don't need all the layers of hazmat crap.

The problem is two-fold:
1) No actual medical skills, so they're basically just bedpan and vomit orderlies
2) recent explanations note that survivors are debilitated for weeks after the disease has run its course.
3) And notably, there's still virus being excreted in urine and sweat for up to 40 days after the disease manifests, so they really can't go anywhere else without rising further infection. For men, virus can be found in semen for 3 months, which may be yet another unsuspected vector for the outbreak continuing.
Guy survives, goes home to the wife, and a week later she's infected.

As for the likelihood of press-ganging medical staff, best wishes there. As someone who's both prior service, and medically trained, I assure you that if someone comes knocking and suggests I get in the van, I promise you I'll kill more people than the disease will if they think that's going to happen in their lifetimes, and I'll be much faster about it than a dose of filovirus.

So if they try that, onesie-twosie or en masse, the first thing they'll need are a lot more FBI guys, and a good supply of body bags.

Reality would kick in in about 2 seconds of pondering: they know all that, so it ain't gonna happen.

And really, what sort of care do you think I or anyone else like me would render while imprisoned in a plague center? Even disarmed and thrown inside, where's my motivation not to simply expose myself, and then rip the masks and gowns off the other prisoner-medics, as my last-ditch finger in Sauron's unblinking eye?
Or simply see to it that all the patients I care for develop giant air embolisms in their IVs and die in about a minute from heart failure? (If I can think of that, bet your ass so can anyone else in the same position.) I won't save anyone, but the conveyor belt bringing the fresh ones in will be running in fourth gear overdrive, and they'd need a dump truck to clean up after my ward. Outbreak solved in half an hour. No patients left. Can I go home now?

So who wants to turn a bunch of prisoners lose under those circumstances?
So again, it ain't gonna happen.

Like every grunt said in a rice paddy in I Corps in the late '60s:
"What are you gonna do if I don't go along with your games, send me to Viet Nam?

Anonymous said...

Hello Aesop,

You are doing great work, glad I found you. I thought you might be interested in seeing MSF's latest email, wherein they make a bunch of lame excuses about Dr. Spencer, and why everyone should come to Africa:


Ex-Dissident said...

Aesop, just look at this image. You and I both know that these numbers are falsely low, but still....


Anonymous said...

Re conscription of medical personnel, they will most likely go through the state databases and anyone not currently working (retired, time off raising kids, etc) will be recruited to work designated pandemic centers.

Evil people have ways of turning thumbscrews, likely threatening families, exposing embarrassing online activity, etc.


Aesop said...



Icepick said...

I wasn't suggesting drafting medicos en masse, but recruiting the medically trained US medicos who have already been infected and survived.. I specifically meant those like the two nurses from Texas and the doctor in NYC who already have had the disease and the other handful brought back from overseas. And I specifically meant for treating future patients in the US, so as to minimize risk of more medical personnel catching the virus HERE. Hopefully they would be resistant to new infections, at least from the current strand on the loose.

Icepick said...

Sorry for not being clear earlier.

Aesop said...

As I said, they can expect to be debilitated for some time to come.

I was questioning a month ago why Brantly wasn't champing at the bit to get back too. Then some of the first-person stories from Ebola survivors (of whom there haven't been a helluva lot before now) stated to get told, and as I said, it has become known that this disease kicks yer @$$ for weeks afterward.

And note, the only reason they're are more survivors now is because there are thousands more victims; thus 10% of 10,000 gets you a lot more of a talent pool than 10% of 50.

So by the time those folks are capable of getting back in the game, the parade will be miles down the road.

Icepick said...

Okay, extended recovery limits what can be expected. That's what I was missing. I'm a bit thrown off by people showing up for photo-ops.

Evyl Robot Michael said...

"Hey, if we had some rope, we could make a log bridge! If we... If we had some logs." http://www.imdb.com/title/tt0097523/quotes?item=qt0392647