Hi. Nice to be back. Fully and completely.
I was going to spend my day off tomorrow coming back to re-visit the entire (and ongoing) Ebola outbreak.
But today, on his blog, American Mercenary went there.
And I replied in comments.
Which occasioned his reply, and now this post, mainly because it's too frickin' big to fit there, it bogged down and choked his Disqus comment server, and I needed this excuse to kick me in the pants and drag me back to this whole thing eventually.
So, let's get to the rat killin':
AM wrote:
Aesop, I've always been a bit in awe of your ability to be so certain about the uncertain.
Why stop with "less than one third"? Why not say "Less than one tenth?" or "Less than one hundredth?" or "Less than one thousandth?"
What gives you any certainty for a bounding of the uncertainty?
It is an interesting question, isn't it?
The same question, asked a different way, is "how do you know even a fourth of cases were accurately reported?" Or "How do you know the population of any given country isn't complete and total bullshit?
And to go one step further, do you know if the rate of under reporting has been consistent or inconsistent? If it is consistent we can still use under reported numbers to track the progress of the epidemic. If the reporting has not been consistent, how would you know?
Here goes:
I appreciate the snark, but unfortunately, WHO selected the "less than 1/3rd" Fudge Factor for those reports some months back, which has been noted on this blog over and over. In fact, it was revised to a higher Fudge Factor the worse things got, because it became crystal clear even to the doorknobs at UN/WHO that the locals were deliberately spinning numbers out their fourth points of contact as a matter of course, and the previous "1/2" Fudge Factor was No Longer Operative. Unless they've taken away the breadcrumbs, the memos to that effect from last July/August/September/October etc. are still available online, including on the Wikipedia page concerning the outbreak:
Note: the CDC currently estimates that actual cases in Liberia, Sierra Leone, and Guinea are two to three times higher than officially reported numbers[1][2][3].(Nota bene that those Wiki links are to a CDC report, Science Magazine, and the LATimes' story on the subject, respectively. From last September and October. So as far as plucking that factor out of my back end, my hands are clean. I can still pull this out of recollection, and I haven't touched the issue since about last December, IIRC.)
And the exact point of the exercise has been that the reporting of the statistics by the involved countries was and is complete and utter bullshit, then, now, and ever shall be. The "1/3" Fudge Factor is the minimum of how much BS to ascribe to the stated numbers. The upper limit is bounded only by the actual population on the ground.
IIRC, I think I only made that exact point about 200 times amidst the height of the crisis.
Like here.
Here.
Or here.
Or probably any number of 200 other posts anytime after July/August.
The entire key to managing this outbreak, by all expert testimony of world-class epidemiologists, is having and effectively deploying sufficient resources, which requires accurate intelligence about where and how bad the outbreak is, and is progressing.
And actually having those resources.
Which has been and continues to be the exact things that have never existed anywhere in West Africa from 400 B.C. to date, inclusive, not least of which because you're dealing with people who have to wear open-toe sandals to count to 20, and have literacy and numeracy rates that make Appalachia look like Caltech and MIT, before we even get into the self-serving corruption problems endemic to the world's poorest former colonies, or the abysmal lack of response to this from outside until well past the date it would have mattered.
Has this spiraled along the exponential mathematical pathway it could have done by now?
Thankfully not. Huzzah.
Why didn't it?
No frickin' idea, anywhere, from anyone.
(Personally, I'm hoping it was the Invisible Hand of the Grim Reaper, selecting out hordes of Darwin Award Finalists with carefree abandon, particularly the 50% of people there who are sure Ebola is caused by witchcraft, and the 45% who are convinced it was cause by the United States practicing witchcraft, but that's just my mischievous nature breaking free for a moment in the sun.)
How bad was it then, and how bad is it now?
We know precisely two things: Jack, and sh*t.
So we don't know where it went, why, or how, and we don't know why it stopped or what was most effective, because we never had any accurate data to go by, not even roughly.
Which makes any official pronouncements about the outbreak from on high as relevant to actual medical science, as astrology forecasts are to actual astronomy.
PAY ATTENTION PLEASE:
This is exactly why the original pronouncements from CDC, like "This will never get to the US", and "We KNOW how to handle and contain this disease", turned out to be total horseshit too: they don't know what they're talking about, and they don't KNOW they don't know what they're talking about, because they're basing their announcements on prognostication based on happygas, NOT on actual scientific analysis or sober reflection on reality and facts on the ground. AND THEY NEVER HAVE.
In the West, it's even worse: the US effectively managed, what, eight or nine simultaneous cases?
And our max capacity is...eleven. Then, now, ever.
A number they had in any of those three countries last March or April, three months before anyone much cared.
The greater point was and is:
This disease will get out, again, and we'll fail to deal with it, again, and next time, once it gets to 12 cases, that city is f*cked.
Twelve cases apiece in two cities and that state is f*cked.
Twelve cases apiece in three cities, and we're Liberia, or Sierra Leone.
And if we're very very lucky then, you might contain it in just one time zone, or on one side or the other of the Mississippi, or the Rockies. At gunpoint.
If it gets to any African or Asian megalopolii, where the number of potentially infected people who can spring for a plane ticket is seven orders of magnitude more than all of the rural African continent, fuggedaboudit.
So how many MOPP suits does your unit have, and how long do they work saturated in infected blood?
And what happens if the factory where they make them is inside the Hot Zone next time?
This is a temporary pause, and we neither know why it paused, or when or where it will return.
We only know that unlike all previous outbreaks, it hasn't burned out and gone away, and now it probably never will.
And as long as we allow them to do so, it's a virtual certainty that people will continue to get on planes there, and bring the disease here and to Europe, in both of which where it won't be noticed immediately, and will thus propagate and spread, and that if it does so over the 21-day incubation period, it could infect enough people that, just like in Liberia, Sierra Leone, and Guinea, it will suddenly spread like wildfire, in cities where the Black Death isn't just hyperbole, but merely dimly recalled actual history. And then the Gods Of The Copybook Headings are going to have their due, in exponential hyperbolic glee, without any nod towards dismissive snark, nor any regard of officialdom's irrational exuberance.
And the bodies of the disbelieving and the slow to respond will be stacked like cordwood.
AM is, by any manner of measurement I can devise, a thoughtful and bright guy, a serving Army officer who evidently survived the recent purges, and in all likelihood, destined for field-grade and higher service.
So while we may occasionally disagree on finer points, I wish him nothing but the best, and hold his posts and comments in high regard, because he takes things apart and puts them together rationally, as a rule, if not entirely. If it were otherwise, he wouldn't be over there to the right on my Blog Roll.
But having noted that the figures we were being fed were pure crapola, pretty much for half a year, which was reported on, sourced, and fact-checked ad infinitum, I can't begin to understand when or why he ever thought it was otherwise, which is the kiss of death to ever understanding this disease or combating it scientifically and efficiently, let alone putting the slightest shred of faith in any official pronouncements regarding it.
My official policy remains: "Ebola: Run for your lives." because the signal to noise ratio is at best 1:10,000, and worse than that the higher up on the panjandrum scale any of TPTB reside.
I didn't think this was news anywhere, but evidently I haven't made the point frequently, forcefully, and cogently enough yet. My apologies for tiptoeing around that 800-pound gorilla.
Comments are wide open.
