Friday, November 21, 2014

Ebola Update 11/21/2014

Looking at the latest WHO data (such as it is, with Liberia as usual electing to someday get around to coughing up some made-up numbers), what you can definitely say is this:

Sierra Leone has new cases in 100% (12/12) provinces in the last 21 days;
Liberia has new cases in 75% (10 out of 15) provinces in that same period;
Guinea has new cases in 50% (16 out of 33) provinces.

Mali's fatalities are all 6 of the confirmed cases, while they are following 327 exposure contacts in the capitol.

Of the confirmed and admitted cases worldwide, there are 100+ fresh confirmed cases per day, every day, and the most intense number of new cases in every instance is in the capitols of the respective countries, in each case among cities of around 1M persons.

In short, none of this points to outbreaks being any sort of controlled, nor even slackening much. The only thing that is certain is that people aren't coming to official treatment centers, thus not getting tested and confirmed as official cases, which seems to suit the respective governments just fine, and feed their penchant for minimizing the degree of infection, which their general illiteracy and innumeracy tends to support as well.

The only actual good news is that no one new - yet - has managed to drag their infected asses into London, Paris, the U.S., or apparently anywhere else, largely due to the recent travel bans and mandatory returnee quarantines, even as international aid to those countries has increased, and thus totally undermining any and all of the specious arguments against adopting those travel sanctions from the outset.

And even that thin reed breaks the minute there's one solid cluster of cases anywhere outside the now four affected/infected countries.

How much worse reality is than the cooked "official" numbers is would be anyone's guess, since the governments involved have notably cracked down on any reporting that doesn't accord with their own rosy figures, and outsider journalism worthy of the name has essentially departed, with most "reporting" done second- or third-hand, via telephone, fly-by, or from the bar outside the relevant agencies' briefing rooms, and a none-too-subtle deliberate spiking of reports and squelching of anything resembling actual reporting here in the US. Note, for example, finding out how many febrile symptomatic travelers have been intercepted is like asking for the nuclear weapon launch codes, or getting a confirmed sighting of Ebola Czar Klain, who surfaced precisely once in the last month for about 15 minutes, then submerged again to points unknown. (The chief benefit of which has been to stop rubbing the entire nation's noses in the limitless and studied assclownery of Drs. Frieden and Fauci, by throwing a shepherd hook around them both, and dragging them out of press briefing rooms non-stop since mid-October. This administration may still not have the first effing clue about handling Ebola, but they at least understand how to control the lazy and stupid bastards in the media, starve them of easy stories, and make further Ebola outbreak coverage resemble a sportscast of submarine races. Mission accomplished.)

The only other mildly cheery observation is that none of the hubris and happygas of officialdom so wall-to-wall prevalent two months ago is in evidence anywhere, so the one thing you can remain assured of is that there's nothing good to report whatsoever, else the gas-passers, and their media lickspittles would be only too cheerfully passing it along by the shovel-load.

So consider this a momentary respite, to continue to get your own stuff together, and hope that things continue in this vein for as long as possible, if not actually improve. If or when things begin to fall apart in W. Africa, or a solid cluster of cases appears outside it, it will become rather hard to cover up, and the sudden panic will bubble a bit higher in each succeeding wave, and become harder to whitewash.


Bezzle said...

"Meanwhile an MSF team is planning to travel to the (Mali border with) Guinea, where new cases of Ebola have been detected, to determine the needs in the area...."

In other words, prepare for both Mali's *and* Guinea's numbers to jump dramatically just as soon the NON-bullshitters arrive on the scene to count the corpses.

Ex-Dissident said...

I see some of the stories that my HHC intraweb directs me to, that don't come up as popular web searches. There was a study published in NEJM at the end of October.

There, mortality from Ebola was seen at around 57 percent for those 21 years old and younger, and at 94 percent for those over 45. These numbers do not square with the reported case and death rates for any of the 3 hot zones.

There is also someone from Mali currently under observation at Bellevue. Initial tests are negative for Ebola.

There is a media clamp down on ebola reporting and stories that should draw attention, are not coming up readily on search engines. However, if you know some specifics about a particular story, it is possible to find them.

The effect of this media clamp down was seen at my recent department meeting when co-chair said with a shrug, "Obola is still something that they want us to talk about, I guess it is still of some concern at HHC heads office". People around me also think the outbreak is over and we can just forget about it.

Ex-Dissident said...

BTW, if this study from Tulane is to be believed, then we have achieved a remarkable survival rate in those treated here. I don't know if it is due to some drugs like zmapp being given early or it is because there are many subclinical or very lightly symptomatic people who contract Ebola, but never come to the treatment centers in West Africa. The people included in that Tulane study were sick enough to report to the treatment centers in Sierra Leone and perhaps they had far more advanced disease than most people who were infected.

Like you said, there are simply too many unknowns, and accurate reporting on this epidemic is nowhere to be found.

Anonymous said...

You probably have covered this already but in case you haven't I find this snippet of a long paper interesting regarding what a government will do.

The Threat of Pandemic Influenza: Are We Ready? Workshop Summary ( 2005 ) Social Disruption and Public Health Lessons In the United States, national and local government and public health authorities badly mishandled the epidemic, offering a useful case study. The context is important. Every country engaged in World War I tried to control public perception. To avoid hurting morale, even in the nonlethal first wave the press in countries fighting in the war did not mention the outbreak. (But Spain was not at war and its press wrote about it, so the pandemic became known as the Spanish flu). The United States was no different. In 1917 California Senator Hiram Johnson made the since-famous observation that “The first casualty when war comes is truth.” The U.S. government passed a law that made it pun- ishable by 20 years in jail to “utter, print, write or publish any disloyal, profane, scurrilous, or abusive language about the government of the United States.” One could go to jail for cursing or criticizing the government, even if what one said was true. A Congressman was jailed. Simultaneously, the government mounted a massive propaganda effort. An architect of that effort said, “Truth and falsehood are arbitrary terms…. There is nothing in experience to tell us that one is always preferable to the other…. The force of an idea lies in its inspirational value. It matters very little if it is true or false” (Vaughn, 1980). The combination of rigid control and disregard for truth had dangerous consequences. Focusing on the shortest term, local officials almost universally told half-truths or outright lies to avoid damaging morale and the war effort. They were assisted—not challenged—by the press, which although not censored in a technical sense cooperated fully with the government’s propaganda machine. Routinely, as influenza approached a city or town—one could watch it march from place to place—local officials initially told the public not to worry, that public health officials would preven

geoffb said...

"Officials Revise Goals on Containing Ebola After Signs of Wider Exposure in Mali"

geoffb said...

"New Ebola Case in Mali Confirmed, Two More Suspected"Just another day like any other day.

Capitalist Eric said...


Aesop said...

The hysterical almost-witness statements of "some guy next door named Costa" are bupkus, and more than likely typical hyperventilating by someone looking for his 15 minutes in the NYPost as somebody who knows something.

Pics, or it didn't happen.

I've done enough CPR and Code Blues in- and out-of-hospital to be a lot less surprised that someone who falls out of a salon chair and/or does a faceplant has a bloody nose or a cut lip, esp. after field intubation, and that's far more likely than that she suddenly started spurting blood from all her facial orifices like some sci-fi flick scene, and that no one actually in the salon noticed anything else wrong until that point.

Thus without any corroboration, "Costa" is bullshitting wildly here, to about 105% degree of certainty, and the dragged out "cover-up" meme in this case is just people who aren't following this, not knowing when they're out of their depth, a day late, and a dollar short.

Find me 5 other eyewitnesses from inside the salon in question, who're willing to state that she was bleeding from the face before she walked in, and at least one of whom took cellphone cam pics of it, and we can talk.

Capitalist Eric said...

Fair 'nuff. Thought I'd point that out as an FYI. This ain't my area of expertise.

Aesop said...

I appreciate the thought, and no harm, no foul.

I'm up on that one because just like the last two times, sooner or later one of the "false alarms" is going to turn out to be Index Patient #3, and the fun and games will begin anew.