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W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

nytimes.com

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Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#31

Post by jMyles »

jfoutz wrote: post #11
jMyles wrote: post #5

Earlier quoted context omitted.

I've never gotten the flu shot, and hadn't planned to this year. I'm in great health; my immune system seems to be functioning extremely well. I never get sick. However, I am concerned about the needle-haystack phenomenon with ebola. Can you link me to a reasonable, digestible abstract about the real pros-and-cons of flu shot?

Is your immune system unusually effective, or do you simply have a lower exposure because people you come in contact with get their vaccines?

I surmise that I just have a good immune system (I'm not sure if it's "unusually" good). I don't go around asking all my friends and colleagues if they've gotten a flu shot, but I don't think they do?

edit: Jeez, downvotes? Did I say something wrong? I'm not trying to troll, just answering the question.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#32

Post by ausjke »

why is USA still allowing people from those countries fly in? the body temperature measure at airport is 99% useless.

When will Duncun's family pay back all those medical expenses here since he lied to the airport before he boarded? Not to mention he put other innocent people in ciritical danger at Dallas.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#33

Post by mikeyouse »

Chromozon wrote: post #23

What scares me the most is the mortality rate. The numbers right now put it at 50%. Catch Ebola. Flip a coin and guess heads or tails. If you guess incorrectly, you die. It will be interesting to see this number once it (inevitably) spreads to "developed" nations with much higher standards of health care.

> What scares me the most is the mortality rate. The numbers right now put it at 50%.

Unfortunately, it's actually worse than that.

The initial predictions about this outbreak were a 50% mortality rate, later estimations put the rate at closer to 70%. To continue your metaphor; You flip two coins and try to guess heads or tails. If you're wrong on either coin, you die.

[1] - http://www.aljazeera.com/news/africa/2014/10/ebola-outbreak-...

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#34

Post by pdabbadabba »

Swizec wrote: post #25
simplemath wrote: post #20

Earlier quoted context omitted.

See reply here for why healthy people should still get a flu shot https://news.ycombinator.com/item?id=8456067

Or I could just avoid touching people if I have the sniffles? And just follow standard recommended practices for limiting the spread of colds (wash hands before/after touching face, only sneeze/cough into your elbow, avoid sick people etc.) Does that not suffice? Can I still transfer the flu even if the virus isn't affecting me in even the slightest possible way?

Well, define "suffice." The methods you list are certainly good things to do, but you you really think that would make it impossible (or even very unlikely) for you to infect someone else? When you sneeze into your elbow, no droplets at all escape into the air? Do you always wash your hands after sneezing or touching your face before touching any other surface? I seriously doubt it.

Meanwhile, what are the risks of getting a flu shot? Effectively zero.

Just get it, please.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#35

Post by hga »

lifeisstillgood wrote: post #10
jerhinesmith wrote: post #3

Earlier quoted context omitted.

I'm really interested to see if the r-naught is sustainable in developed countries. This paper ( http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2... ) projects it as between 1.0 and 2.0 -- the nurse in Dallas makes it at least 1 for the first US case, but it could be a few more weeks to know if she was the only one.

For others who wondered about the R-naught reference - how many people one infected person will then onwards infect. http://en.m.wikipedia.org/wiki/Basic_reproduction_number Measles is 12-18, Ebola 1-2. Before that makes you feel comforted, 1918 flu had r0 of 2-3. Great.

Problem is, the data from West Africa is so bad in quality it could easily be 3 (e.g. I believe that's in line with the CDC's worst case estimate for January).

Which to echo simplemath is deeply scary.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#36

Post by jrkatz »

ianlevesque wrote: post #28
ColinDabritz wrote: post #21

Earlier quoted context omitted.

Current Flu shots have few side effects, and decent protection. I believe there is a chance of mild flu-like symptoms, a chance of ache near the injection site for a day or two. The CDC has changed stances to recommend everyone (over 6 months) get a flu shot every season. The CDC has a good rundown: http://www.cdc.gov/flu/about/qa/flushot.htm

The injected flu shot has completely inactivated (colloquially, dead) virus and cannot cause flu like symptoms. Recent formulation removed the egg allergy restrictions as well. There's effectively no reason for anyone to avoid being vaccinated.

My understanding has always been that since the dead virus works by triggering an immune response, 'symptoms' (that are actually part of the immune response, e.g. fever, soreness) can still occur, though they end quickly, as the body easily 'beats' the non-reproducing virus. Is this not the case?

Regardless, a person with nothing to fear from the flu getting the shot anyhow and having a fever for a few hours sounds like a cakewalk compared to what happens if they don't and infect me, even through my vaccination: I am very asthmatic and the flu for me can easily turn into months of bronchitis, or -- even worse -- pneumonia and hospital trips.

People like me rely on herd immunity to supplement our own vaccinations. Please get vaccinated.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#37

Post by pdabbadabba »

ausjke wrote: post #32

why is USA still allowing people from those countries fly in? the body temperature measure at airport is 99% useless. When will Duncun's family pay back all those medical expenses here since he lied to the airport before he boarded? Not to mention he put other innocent people in ciritical danger at Dallas.

I'm sorry, did Duncan's FAMILY lie on the form? While we're at it, did Duncan? It's fairly widely reported that he did not know that the woman he helped had ebola. Apparently her family had been in denial, and told people she was experiencing complications from the pregnancy.

>Duncan did not know he'd been exposed to Ebola by the pregnant woman, says his brother-in-law, John Lewis.

>"The family said that the girl did not die from Ebola; they continued to say it until they went and buried this girl," says Lewis.

http://www.npr.org/blogs/goatsandsoda/2014/10/09/354645983/f...

And in any case: how about you spend a little more time trying to feel compassion for people like you who just lost a husband/father/son and a little less trying to figure out who should get the bill.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#38

Post by TheOtherHobbes »

danieltillett wrote: post #29
simplemath wrote: post #18

Earlier quoted context omitted.

There's already limited evidence that some transmission is occurring via atomized saliva/mucous. A truly airbone variant could cause a "get in your bunker and ride it out" kind of event.

Yes Ebola can be transmitted that way, but it is an unlikely route. The way Ebola is constructed it is very unlikely to become airborne [1], but it could increase in natural reproductive efficiency (R0). We really have no idea of the R0 for Ebola right now as we don’t have the people on the ground recording what is happening in the community. Ebola does not have to become airborne for it to be a problem. Polio is not…

Not everyone is convinced:

http://www.cidrap.umn.edu/news-perspective/2014/09/commentar...

Some health workers have been infected even though they were equipped with significant protection.

Clearly infection rates in unprotected populations would be non-trivial, even without the kind of mutation that would make Ebola as infectious as a rhinovirus.

Given that many public spaces in Western cities are more densely populated than equivalent spaces in Africa, and there are much greater numbers passing through them, I'm genuinely concerned this has the potential to blow up in a vey bad way.

I'm not heading for the hills yet, but if case numbers begin increasing I'm going to consider it seriously.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#39

Post by nostrademons »

simplemath wrote: post #18
danieltillett wrote: post #14

Not stopping this outbreak with all the resources we have is running a massive natural experiment in how well adapted Ebola can become for efficient human-to-human transmission. As a zoonotic virus Ebola in its wild state is very unlikely to be optimised for human-to-human transmission. Every new case is increasing the chance that a new strain will arise that will be efficiently transmitted between people. I am not t…

There's already limited evidence that some transmission is occurring via atomized saliva/mucous. A truly airbone variant could cause a "get in your bunker and ride it out" kind of event.

Usually the progression of most diseases is toward easier transmission but lower mortality rates. Viruses that kill their hosts have a hard time becoming endemic.

My prediction for Ebola is that it eventually becomes like norovirus (stomach flu): a common gastrointestinal ailment that is painful and inconvenient, but seldom lethal, and spreads easily through contaminated surfaces.

Re: W.H.O. Forecast for Ebola Worsens as Mortality Rate Rises

#40

Post by throwaway5752 »

simplemath wrote: post #18
danieltillett wrote: post #14

Not stopping this outbreak with all the resources we have is running a massive natural experiment in how well adapted Ebola can become for efficient human-to-human transmission. As a zoonotic virus Ebola in its wild state is very unlikely to be optimised for human-to-human transmission. Every new case is increasing the chance that a new strain will arise that will be efficiently transmitted between people. I am not t…

There's already limited evidence that some transmission is occurring via atomized saliva/mucous. A truly airbone variant could cause a "get in your bunker and ride it out" kind of event.

People here are so inclined toward numbers that I fear people are latching basic reproduction rate (R0) without proper context. The transmissibility of a disease is not some kind of invariant property of the pathogen.

It's not meaningful to talk about the R0 of Ebola in any kind of historic sense. Jungle/rural outbreaks are going completely different from urban ones, and this is a very different outbreak than previous ones. Very simply, if you have a 100% transmissible disease and are in a sealed room with 0 people until the pathogen is gone, your R0 is zero. If you're in a room with 100 people, it's 100.

I guess I'm saying that I'd love a reliable citation for your claim. Changes in R0 aren't necessarily evidence of that, and those claims (especially airborne transmission) is just needlessly and baselessly worrying people.

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