Saturday, September 15, 2018

Ebola 2018: Cautious Optimism Is In Order

Wikipedia is behind the curve, but going direct to the source, per the latest (12 Sep 2018) WHO progress report, this outbreak is slowing notably.

Good News:

1) Deaths are only at 91, up just under 20 since 3 weeks ago, and far better than the 144 we expected were this running unbridled, with a perfect r-naught of 2. So if the numbers are accurate, their efforts to contain it are bearing fruit.

2) Total cases, nearly all confirmed, (confirmed, probable, and suspected) are at 154, also well below the expected 234 from 3 weeks ago if this were continuing to run rampant.

3) The still-experimental vaccine has been administered to over 8900 persons, including nearly 2500 health care workers. (Which has also ended the specter of a baker's dozen of infected do-gooders returning to unaffected countries, for million-dollar treatment prototcols in scarce BL-IV hospital suites.)
Between that, and the ETCs drastically curtailing the local idiocy of playing with dead bodies loaded with active virus, they seem to have finally started beating this thing down to a level that can eventually be pinched off.

This is what happens when you properly dog-pile the disease immediately, instead of wating until you have 3000 active cases in three countries teeming with poor, uneducated people including cramped cities, which was how 2014 went so sideways.
Having a trial vaccine, which didn't exist whatsoever in 2013, that seems to be largely effective against this strain is also paying vast benefits.

Bad News:

1) The virus did jump to Butembo, a city of >1M, with trading links to nearby Uganda.
From one initial contact, there are now six cases, and several more suspected and awaiting confirmation, in an area originally outside the outbreak zone, and without Ebola treatment centers or any medical response.

2) Contacts being tracked are down from 3,421 to only 1,751. But this is because of difficulties following the contacts due to the previously mentioned socio-political difficulties in that area. In other words, they can't travel to find them, so they're not following a crap-ton of people they would like to and ought to be following. That's still very concerning, and could allow this outbreak to blossom out of control again at any time.

This still bears some watching, but seems to be calming down notably from the initial appearance.

In short, this is 19th century medicine working, far more than 21st century medicine, which latter has only contributed the actual vaccine. The rest is isolation, vaccination, and not following 6th century practices amongst people with a 3rd grade education and $90 average annual income.

Now, if we could only get them to stop eating roadkill and scavenger species "bushmeat", provide them clean running water, provide adequate sewage disposal, and teach them to wash their hands frequently...

But I'll settle for them not inflicting the Ebola apocalypse on us this year.

If current efforts continue in this trajectory, they should be able to wipe this flare-up out in a couple of months, barring any more wandering infectees carrying it to parts unknown or bigger cities.

Fingers crossed.

Unless it gushes out of control again, we'll leave off talking about it for a month or so, and hopefully only bring it up again if and when it's over.
But as a couple of recent return flights to the US from SWAsia, containing returning Muslim pilgrims from the annual hajj (a permanent annual wet dream vector for accidental or on-purpose worldwide dissemination of biological pathogens), demonstrated in the intervening space, our current precautions and response to any infectious disease and hosts of same arriving here are completely farcical and totally inadequate, anywhere in the US (or, probably, anywhere period) unless the point of the exercise was to ensure that every disease that gets here ought to be spread around like pouring water on a gasoline fire, until everything around goes up in flames.

If you assume a priori that TPTB are malignly stupid, incompetent, and ineffective, you'll achieve a 99% success rate by believing that everything they do or say is exactly wrong.

In short, as usual with so many things, if things start to slide, YOYO: You're On Your Own. Make all your preparations accordingly.

As noted, with droplet precautions, Ebola will not low-crawl up your driveway to butt-rape you. You only need a 50' perimeter to keep it away from you, provided you immediately quarantine yourself should it appear nearby, and you self-seclude before it becomes widespread in your area. If you don't do that, it's going to spread, you're going to catch it, and then you're probably going to die a most grisly death.

And even if/when we have a reliable and generally available vaccine, that only leaves 20 other virulent hemorrhagic fevers with no vaccine, and any number of drug-resistant bacteria, like the new strains of TB and VD, all still floating around out there.

In short, kids, learn basic infection control: you will see this material again.


Reltney McFee said...

Aesop: "common" sense oozing (so to speak) from every paragraph!

Beans said...

You make far more sense than most of the chowder-heads at the CDC. Hmmmm. Wonder why?

Glad that the African powers decided to allow dogpiling, and sounds like they actually helped for once.

As to the shite-show in New York regarding the Hajj 'pilgrims,' the plane should never have been allowed to deplane anyone. Should have been refueled and sent to some SAC base in North Dakota or Arizona. To actually sit and enforce a quarantine.

One of these days a flying box of plague rats is gonna get us in real trouble.