Sunday, December 30, 2018

Year End Ebola Update

As multiple commenters have observed, we've brought an M.D. exposed to Ebola in DRC, but asymptomatic and not contagious, back to Nebraska for observation.

Ok, fine, so far.

This is how it's supposed to work for everyone exposed, even TV spokeshole doctors and whiny Mimi Crybabypants "nurses" who think they should have the right to run hither and yon and hopefully not start infecting people when they pop a fever. Or not. Because they're special, and the sun shines out of their anuses, apparently. Contrary to quarantine policy and black-letter health laws going back 700 years.

Sending the guy to quarantine at Nebraska Medical Center is fine too, as it's home of one of the four BL-IV treatment centers with the 11 actual BL-IV beds extant in North America, should that become necessary, and their patient becomes symptomatic.

The gaping flaw in what they're doing is that they plan to observe Doctor Oopsie for two weeks - fourteen days.

But Ebola Virus Disease incubates for between 1 and 25+ days, NOT JUST 14 DAYS(!), and while 99% of cases appear in 25 days or less, 1% of cases don't show up until after 25 days.
(Another very small but non-zero percentage of persons exposed are asymptomatic, but may still carry the disease and be infectious without symptoms. Nobody is talking about that last part, either, because if you pretend it doesn't exist, you don't have to deal with it. Until you do.)

Geniuses in action, right there.

It will be cold comfort to anyone subsequently infected if they stop checking Dr. Oopsie on Day 15, and he doesn't become symptomatic, and thus infectious, until Day 18, or 23. Especially if he celebrates the end of his quarantine at the mall or movie theater, coughing out virus onto random passersby.

If you're going to half-ass a quarantine (and clearly, they ARE doing exactly that in this case), better to not do one at all, and just tell people to kiss their asses goodbye, because - EXACTLY LIKE IN 2014 - TPTB are playing roulette with the entire populace, because for them, that's more convenient.

Sleep tight.
And cross your fingers.

Oh, and that Congo outbreak itself?
As we warned, it's accelerating out of control, growing from 503 cases on 11/30 to 692 cases as of 12/21, a week ago. IOW, more new cases in the last 21 days than the total number of cases for the first ten weeks from August to mid-October.
The experimental vaccine is still, AFAIK, 100% effective, but the outbreak has blown through every containment ring like a brushfire in a gasoline-soaked forest.
Buckle up. 2019 is looking seriously fugly.
And that doctor is just the first case we're watching.
He won't be the last.

And for those unwilling to follow this closely, bringing him here is not the problem.
Bringing back 12 or more symptomatic patients is the problem - because we don't have that 12th Ebola bed - as is cessation of his/their infection monitoring before the likelihood of infection gets to at least a 99% chance of safety.

And if you bring 100 exposed people back, that statistically guarantees that one of them will be the 1% long period incubation that you'll release into the wild here, and we're off to the races.

A quarantine has traditionally meant 40 days ("You could look it up." - Casey Stengel), and that standard should apply yet again, in this case. Six weeks' surveillance, not two.
Anything less is rolling the dice, and we're all the chips in that wager.


Peter B said...

How much time elapsed between the suspected exposure and the start of the two week quarentine?

Eskyman said...

So for New Year's Eve, instead of lowering the ball we get the boom lowered on us.

Well, that sure puts a damper on the New Year's fizz!

Not for the first time I'm kinda glad that I've already got one foot in the grave, but I wish I could think of something to do about this instead of simply resigning myself to it. I'll work on my list of "People The World Would Be Better Off Without," maybe I can take one or two of them with me when I go!

Anonymous said...

I can careless if this is the top place to send these PTs. IMO, best place to send them is not here.

Skip said...

So, how did he get here? Plane full of pax?

bobbookworm said...

I think that should be 591 not 691...not that that isn't bad enough with the locals trashing health facilities in a couple of cities and the health workers having to stand down for several days due to election violence.

Beans said...

This is why selfish medical workers who are working oversees so they can facebook "Look at me Saving the World" should be isolated in some far-off location, like Wake or Johnston Islands. Far away from the mainland, far far away.

Better yet, set up a facility there (Africa) to keep these cases from travelling.

So how exactly did Doctor Disease get here? Did they sterilize everything he was in contact with before, during and after the travel? Or did they stick him in a bio-pod thingy that is a completely enclosed and recycled environment? And at whose expense? Did he have insurance or family paying for it, or are we as a nation coughing up (hopefully not actually coughing up...) the bill for Dr. Killdare?

Assholes, assholes everywhere.

Lee Van Queef II said...

Looks like Dr. Ebola will need his eyeball juice tested for viroids with a large gauge needle in addition to cell cultures and antibody tests.

I would include a daily ice water enema for good measure.

Scott halloween said...

I thought I read somewhere that coidial sivler cured it and the USA threw a fit and told the country using it to quit or loose all,funding.
Anybody else remember ?

Anonymous said...

/sarc/ Yeah, that a lots of vitamins./sarc off/

Aesop said...

99% chance that any news of someone "curing" this with colloidal silver, was on a site selling colloidal silver. Just a hunch.

Africa is full of witch doctors.
You don't figure someone there already tried that??

But if anyone wants to try it, airfare to Congo is about US$800.
Take your little Silver Maker 2000 with you along with a plug converter, get infected, and give it a go. Write back and tell us how that works out.

Scientific adventure awaits.

Karl said...

Send him back. Doesn't he know the US is under new management.

Remember when Ebola stayed in Africa. Ushanka remembers.

Aesop said...

692 is the publiched number per the link as of over a week ago, worth every penny you pay for it.
I didn't cut to the current straight-from-the-source WHO reports, and Wiki is always a few days behind those.

Bear in mind African Accounting, which begins with taking shoes off, and ends with applying a correction factor to get actual numbers.

In 2014, the correction factor was to multiply all reports X3 to get a conservative estimate.

That's not the case this time, yet, as far as we know, but it will probably kick in imminently, given the usual causes.
692 is bad, but jumping it to >2000 moves the OShit Pandemic Meter up two notches at once.
As I said, that doesn't appear to be the case there - yet.

Aesop said...


Keeping him here is not the problem.
Bringing back 11 more is the problem - because we don't have that 12th Ebola bed - as is cessation of his/their infection monitoring before the likelihood of infection gets to at least a 99% chance of safety.

And if you bring 100 exposed people back, that statistically guarantees that one of them will be the 1% long period incubation that you'll release into the wild here, and we're off to the races.

A quarantine has traditionally meant 40 days, and that standard should apply yet again, in this case. Six weeks' surveillance, not two.

Keypounder said...

I went and looked and the difference between the 591 the WHO is reporting- link

and the 692 that Wiki is reporting, is that the Wiki site includes suspected/not confirmed cases.

The real numbers are unknown, and will remain so. The big issue is where are new cases popping up?........

Aesop said...

That would be everywhere surrounding.
And doesn't count the suspected cases they don't know they don't know about, in the sections closed because of violence, lack of roads, etc.

Like I said, "yet" is the final word in every explanation of those numbers.

Aesop said...

Oh, and most of the suspected cases (not all, but most) pan out.

Science and optimism are generally mutually exclusive.

bobbookworm said...

OK I finally see where you got that (scroll down Bob!) and it is a good example of their reporting. If you follow footnote 1 from Wikipedia's box on the right, that takes you to an 'official' table that shows fewer cases even though it is updated. Both come from the same DRC ministry of health source. Seems the 'suspected' cases tend to swing they jumped from 200 plus one day to 2 the next day near the end of Dec. and they are showing 8 now. As you have pointed out, reporting over there sucks. Also, I wouldn't be too quick to say not this time yet on the 3x factor as the geographic dispersal is pretty large and still increasing (new health district reporting a case). Lotta jungle and people between those cities.
This medical blog... is a good source of information. He posts links to a lot of ancillary articles about the general situation over there besides a daily update of the numbers.

mtnforge said...

The finer points of the human extinction movement in action.
Maybe, because of your timely intelligence Aesop, my loved ones, tribe and allies will survive, and can then gloat at the finer points of natural selection of the truly dumbass members human race.
There's that at least.

Anonymous said...

If the vaccine is effective, shouldn't the next step be to immuniz potential medical staff in state side hospitals that have the capability to handle these patients ?

Anonymous said...

So we about level 9 or 10 on the exponential fun scale?

Did you see this report?

Bats may be confirmed as the long suspected reservoir species for Marburg and Ebola? Glad there aren't any bats here in the United States that could possibly become an endemic Ebola source? /sarc


Anonymous said...

The CDC should be encouraging increased production of this new Ebola vaccine. Spend real money for actual product and increased manufacturing capacity, rather than useless gun violence studies.

Even if we don't need it this time, we will need the vaccine in about another three years if things go the way they have been. I sincerely hope that we won't need it for another three years.


Anonymous said...

Also don't copulate with chimpanzees which they are known to do.

James said...

Wow,the way info in this article is presented you would think some folks almost want the virus to hit the continental US,insanity I tell you!

Why the hell cannot a area be set up in Africa with airdrops/excellent equipment ect. to deal with cases?I would also say out in the middle of nowhere to a degree from villages/towns/cities so worst case full blown pandemic hits center you can gas bomb it and burn everything without killing locals uninfected.

Again,in case things hit the US why not the same setup/setups,a place to deal in middle of no where/well supplied and folks working there are aware worst case scenario will be burned to the ground to keep an out break from spreading,folks would still volunteer to fight the disease am sure, bless them!

Differ said...

Prob at least one in one hundred infected long period at 1% is 64% (1-prob 0/100= 1-.99^100)
Still not good.
Good reminder on meaning of quarantine; sad commentary on ignorance of the population about things most of us knew once upon a time.

Anonymous said...

@james - You're maki' too much sense.


Anonymous said...

Aesop, Why does the picture of the Ebola virus look like a nematode and not like other viruses?

Aesop said...

Isn't that a Hanukkah question?

Anonymous said...

This should be interesting...

Aesop said...

Or nothing.

So far, this is just RUMINT.
Until they confirm a case by testing, it's not worth even noting in passing.

Anonymous said...

Q: Where do most flights in or out of DR Congo originate or terminate? Paris/Amsterdam I am guessing but that's all it is, a guess. This Dr. Ahole who went to Nebraska no doubt flew at least part of the way on a private plane, partly on commercial airlines.

Here is an interesting tidbit, don't know it it's related to the ebola thing or not:

"WASHINGTON (Reuters) - President Donald Trump said on Friday U.S. military personnel had deployed to Gabon in response to possible violent demonstrations in the Democratic Republic of Congo following a disputed presidential election there.

In a letter to congressional leaders, Trump said the first of about 80 military personnel arrived in Gabon on Wednesday. . . "

The beautiful country of Gabon is only a couple of hundred miles from the beautiful country of DR Congo with it's beautiful diversity and multiculturalism :,22.613713,5z

Not to be too conspiracy minded but WTF does the U.S. Govt. care about Gabon? Isn't there always a disputed election, disputed with M-16s and AKs? So what? They settle their disputes with 55 grains of lead over there.

Aesop said...

1) Those personnel were overwhelmingly augmentation to the US embassy force and evacuation facilitators, should that become necessary, not presidential election peacekeepers. We do that all the time with the Turd World, because we have to.
A primary contingency mission of every Marine BLT afloat is emergency embassy and dependent evac. Sending in some guys to tally heads, pre-survey routes, LZs, recon the potential hostile forces and allies, etc. and augment the small embassy detail is common sense.

2) Most flights to DRC originate/terminate everywhere.
I.e. Boston, Atlanta, NYFC, Rio, Buenos Aires, Cairo, Capetown, Nairobi, Rome, Paris, London, Amsterdam, Delhi, ad infinitum.

The only way to quarantine a country like DRC is to also contain all the contiguous borders, and those countries as well, because ain't nobody blockading miles and miles of equatorial rainforest jungle.

That's the exact problem thereabouts.

Anonymous said...

Excellent explanation of the reason behind the 80 man team being sent to Gabon. Conspiracy theories are usually just that, theories. The Yahoo news story was unfortunately not clear that an evacuation of U.S. citizens including embassy staff might be necessary because of the precarious situation and that was the reason for the team being dispatched, not ebola.

BTW Gabon is also a big oil and mineral exporter.

It sounds like it's almost impossible to properly quarantine a place like DR Congo or its neighbors but stopping all international flights out of the area should be done anyway if ebola continues to spread, something which seems likely.