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The Mathematics of Ebola Trigger Stark Warnings

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Re: The Mathematics of Ebola Trigger Stark Warnings

#121

Post by DanBC »

ghshephard wrote: post #95
hueving wrote: post #92

Earlier quoted context omitted.

>It's a calculated risk, sure, but I don't think the Thalidomide example is particularly relevant. It's very relevant. It shows that people are too willing to take risks with major unknowns. Where do you make the cutoff with your drug experiments? Only people that are certain to die? People with high exposure risk? People that are having difficulties recovering? Any selection you pick there is completely arbitrary be…

"Where do you make the cutoff with your drug experiments? " I don't know where you make the cutoff, but I'm comfortable saying that its somewhere below having a disease with a 50% mortality rate in under 14 days. I'm pretty much okay taking any risk at that point.

What if the risk was survival but with locked-in syndrome and constant very high pain? Or survival but severely brain damaged - no ability to feed yourself; or talk; or understand the conversations of other people.

Re: The Mathematics of Ebola Trigger Stark Warnings

#122

Post by cstross »

waps wrote: post #85
narrator wrote: post #75

Earlier quoted context omitted.

The American perspective is to solve every problem with the military or money. We believe that violence and more money are the only effective solutions to every single problem the world faces. Original thinking just doesn't happen. A creative solution would be to temporarily halt all regulations on anti-ebola drug development and let them experiment on any willing person in Liberia who wishes to receive treatment. Th…

And who pays for the, potentially unbounded fallout from that decision ? Let's say this happens : http://en.wikipedia.org/wiki/Thalidomide (First read about the advantages of the drug, then move to the crises. in particular the birth defects crisis) And please don't just say that people knowingly took the risk, read the article first to see how that played out. People won't accept the consequences of decisions made u…

There are pros and cons for both sides of this argument.

The question is whether to suspend normal precautionary procedures during an extraordinary situation, not whether to ditch normal precautionary procedures which exist for very good reasons (see the Elixir Sulfanilamide disaster for why):

http://www.fda.gov/aboutfda/whatwedo/history/productregulati...

You're rightly concerned for the possible side-effects of using untested treatments on people during an emergency. But flip the question around: who's liable for not deploying an available experimental treatment that is later determined to work, but only after tens of thousands have died while it sits, unused, on the shelf due to lack of test data?

Re: The Mathematics of Ebola Trigger Stark Warnings

#123

Post by DennisP »

narrator wrote: post #75
ChuckMcM wrote: post #23

Going 'meta' for a moment, this is a tragedy of huge proportions, the question I have been considering is whether or not it is even possible to avoid? Updates from MSF which highlight the level of mistrust and superstition amongst the infected population, where people hide their sick relatives from isolation wards and take them back to their village. We cannot exactly put a giant fence around the place (and not that…

The American perspective is to solve every problem with the military or money. We believe that violence and more money are the only effective solutions to every single problem the world faces. Original thinking just doesn't happen. A creative solution would be to temporarily halt all regulations on anti-ebola drug development and let them experiment on any willing person in Liberia who wishes to receive treatment. Th…

I'm a libertarian too, and agree that the FDA is overly cautious, but I don't think drug research is an effective response to an acute epidemic. When something's growing exponentially you have to stop it quickly.

Re: The Mathematics of Ebola Trigger Stark Warnings

#124

Post by rwallace »

I recommend anyone proposing solutions to the crisis first read this explanation of events to date: http://www.vanityfair.com/politics/2014/10/ebola-virus-epide...

In particular, the history of events to date makes it clear it is not a case of the world doing nothing. Back in the spring, when there was reasonable hope that sending a bunch of foreign doctors could stop the outbreak, that was done - for a little while, it even looked as though it had worked.

Unfortunately, it didn't, by a long shot. Now WHO and MSF want to repeat that strategy on a much larger scale.

My opinion is that this is a very bad idea. The epidemic in West Africa not going to be stopped. That window of opportunity closed months ago, if it was ever open. If we send in thousands of doctors now, a large percentage of them will end up dead, and the epidemic still won't be stopped. It will be a waste of life, and at that, of the lives of trained doctors and nurses who will be all too soon and badly needed if the epidemic does start hitting other regions where the outcome would still be in doubt.

And no, sending in the military is not the answer. Not only does "it's for your own good" not morally justify aggression, but by further eroding the trust of the local population for authority in general and foreigners in particular, it would make matters worse, not better.

The affected area needs to be sealed off so the disease can't spread to the rest of Africa and the rest of the world. By all means airdrop medical supplies to Liberia, but don't for heaven's sake start sending hordes of doctors, soldiers and camp followers there to create more fodder for the virus.

Re: The Mathematics of Ebola Trigger Stark Warnings

#125

Post by JulianMorrison »

> In a worst-case hypothetical scenario, should the outbreak continue with recent trends, the case burden could gain an additional 77,181 to 277,124 cases by the end of 2014.

What I wonder is: why do they think it will stop? What's going to put a brake on the epidemic's explosion? This is not a world where a disease can burn itself out on the local level by simply killing everyone susceptible.

Re: The Mathematics of Ebola Trigger Stark Warnings

#126

Post by JulianMorrison »

rwallace wrote: post #124

I recommend anyone proposing solutions to the crisis first read this explanation of events to date: http://www.vanityfair.com/politics/2014/10/ebola-virus-epide... In particular, the history of events to date makes it clear it is not a case of the world doing nothing. Back in the spring, when there was reasonable hope that sending a bunch of foreign doctors could stop the outbreak, that was done - for a little while,…

A cordon sanitaire won't work. You're betting against the ingenuity of every single person trapped behind it, and the inevitable infected refugees are very motivated to confound efforts to find them.

Re: The Mathematics of Ebola Trigger Stark Warnings

#127

Post by barrkel »

Padding wrote: post #104
ghshephard wrote: post #95

Earlier quoted context omitted.

"Where do you make the cutoff with your drug experiments? " I don't know where you make the cutoff, but I'm comfortable saying that its somewhere below having a disease with a 50% mortality rate in under 14 days. I'm pretty much okay taking any risk at that point.

You didn't get the point of the argument. What do you do when something with 51% mortality in 15 days comes up? And then something with 49% in 13 days .. where do you draw the line? And what do you do when people continue to cry out?

The existence of a Sorites paradox doesn't mean that heaps and grains are not different things.

Re: The Mathematics of Ebola Trigger Stark Warnings

#128

Post by ohitsdom »

IvyMike wrote: post #38

I had a discussion with a friend, and he pointed out that Malaria infects something like 200 million people a year in Africa, and kills around half a million. It's brutal. So this new paper is projecting that Ebola deaths in Africa will be about as common as Malaria deaths. I guess I'm trying to draw any conclusions or imply anything here other than life in Africa is pretty freakin' tough.

The most important difference is that a Malaria-infected person isn't contagious.

Re: The Mathematics of Ebola Trigger Stark Warnings

#129

Post by rwallace »

joesmo wrote: post #61
ChuckMcM wrote: post #23

Going 'meta' for a moment, this is a tragedy of huge proportions, the question I have been considering is whether or not it is even possible to avoid? Updates from MSF which highlight the level of mistrust and superstition amongst the infected population, where people hide their sick relatives from isolation wards and take them back to their village. We cannot exactly put a giant fence around the place (and not that…

I think you bring up some good points and I don't mean to discount the moral dilemma here, but in reality such moral considerations are hardly ever considered. I don't think the article is suggesting invasion, but if that was the best solution, I don't see a problem with it if it prevents an epidemic or worse, a world wide pandemic(especially if it mutates into airborne transmission). After all, the US has invaded ma…

I will suggest that given the historical data of "the US invaded many other countries, and it generally turned out to be a really bad idea," the correct conclusion is not "so let's go ahead and invade a few more countries," particularly when there is plenty of specific reason here to believe such action would make things worse not better.

One of Liberia's biggest newspapers recently ran an editorial claiming the Ebola epidemic was deliberately created by the US government. If that's the sort of paranoia that exists now, what do you think it's going to be like if thousands of Americans with filter masks and machine guns start flooding into the country? In addition to all the usual bad results, you're going to get a lot of people hiding and running - carrying the virus with them.

Re: The Mathematics of Ebola Trigger Stark Warnings

#130

Post by rwallace »

JulianMorrison wrote: post #126
rwallace wrote: post #124

I recommend anyone proposing solutions to the crisis first read this explanation of events to date: http://www.vanityfair.com/politics/2014/10/ebola-virus-epide... In particular, the history of events to date makes it clear it is not a case of the world doing nothing. Back in the spring, when there was reasonable hope that sending a bunch of foreign doctors could stop the outbreak, that was done - for a little while,…

A cordon sanitaire won't work. You're betting against the ingenuity of every single person trapped behind it, and the inevitable infected refugees are very motivated to confound efforts to find them.

No, I'm betting the world's medical resources can contain the occasional small outbreak created by the occasional individual who gets past the cordon, particularly since such containment doesn't have to last forever. You can't put out an inferno, but you can put out scattered sparks.
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