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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

#41

Post by danieltillett »

nostrademons wrote: post #39
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.

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.

Firstly, this might happen over millions of years, but this is unlikely to occur anytime in the short term. Many viruses that have been in the human population for a long time have quite high death rates in immune naive populations (think of small pox as an example).

Secondly, the mechanism of transmission of Ebola is quite closely tied to the cause of death. To be transmitted it needs to turn you into a massive viral factory and then make you very “leaky” so the virus gets spilled out into the environment. Any mutations that decrease mortality are also likely to decrease the infectiousness of Ebola

Thirdly, Ebola is starting off from a very high death rate. Even if there was a major decrease in the mortality rate (say it only kill 5% instead of 50 to 75% people), it would still be a huge problem.

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

#42

Post by throwaway5752 »

TheOtherHobbes wrote: post #38
danieltillett wrote: post #29

Earlier quoted context omitted.

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 popul…

The linked article is making a nuanced claim in general about aerosol transmission in general, not a specific change in the structure of the Ebola virus.

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

#44

Post by pdabbadabba »

TheOtherHobbes wrote: post #38
danieltillett wrote: post #29

Earlier quoted context omitted.

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 popul…

I'm not a doctor or epidemiologist, but I think, as a matter of common sense, that there's a distinction between being an "airborne contagion" and being merely transmissible through saliva. We know that Ebola can be transmitted through saliva, but it does not cause any symptoms that would tend to aerosolize that saliva (coughing or sneezing).

This would mean that you're not at all likely to get Ebola if you just happen to stand near an infected person, but we will still occasionally hear of people who seem to have been infected "through the air." These, one would think, would tend to be healthcare workers since they see patients at their sickest and may be performing procedures (e.g. intubation) that aerosolize saliva.

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

#45

Post by azakai »

jerhinesmith wrote: post #3
simplemath wrote: post #2

I'm trying to remain calm about this, but its growing increasingly difficult. We're not far off pandemic territory. 10k new cases per week ? Very very alarming.

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.

> 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.

Since it's a single case though, this is far from statistically significant. We don't know what R0 will be in the US.

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

#46

Post by dghughes »

jMyles wrote: post #31
jfoutz wrote: post #11

Earlier quoted context omitted.

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.

It's called being an asymptomatic carrier look up Typhoid Mary.

You may be infecting elderly and babies but are unaffected, as others have said a flu shot isn't so much about protecting you it's about people around you. My 70 year-old dad has IPF his lungs are shot and if he catches the flu he's as good as dead.

It's frustrating the ambivalence or apathy or just outright paranoia is so prevalent these days. At my workplace out of 400 people one year only 3 people got a flu shot; myself and two others. The majority are 20-somethings and others who don't get the concept of a vaccines.

I feel like saying "We don't care about just you we care about everyone!" but it's not a very good catch phrase.

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

#47

Post by Swizec »

pdabbadabba wrote: post #34
Swizec wrote: post #25

Earlier quoted context omitted.

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 g…

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

To be perfectly honest, it's not about risk. It's about the nuisance of yet another errand to run. Unfortunately that small-ish barrier is often enough to prevent me from doing things that don't feel absolutely essential.

Hell, I wonder where I would even go to get a flu shot ... my general physician? I don't even know where their offices are ...

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

#49

Post by hga »

dghughes wrote: post #46
jMyles wrote: post #31

Earlier quoted context omitted.

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.

It's called being an asymptomatic carrier look up Typhoid Mary. You may be infecting elderly and babies but are unaffected, as others have said a flu shot isn't so much about protecting you it's about people around you. My 70 year-old dad has IPF his lungs are shot and if he catches the flu he's as good as dead. It's frustrating the ambivalence or apathy or just outright paranoia is so prevalent these days. At my wor…

Unfortunately, given the minuscule coverage compared to what's needed for good herd immunity, approximately 134.5 million doses distributed last year, and 100 million so far this year (http://www.cdc.gov/flu/professionals/vaccination/vaccinesupp...), while your advocacy doesn't hurt, how well can you ring fence your father? (As in get all the people he comes into contact with inoculated.)

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

#50

Post by hga »

Swizec wrote: post #47
pdabbadabba wrote: post #34

Earlier quoted context omitted.

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 g…

> Meanwhile, what are the risks of getting a flu shot? Effectively zero. To be perfectly honest, it's not about risk. It's about the nuisance of yet another errand to run. Unfortunately that small-ish barrier is often enough to prevent me from doing things that don't feel absolutely essential. Hell, I wonder where I would even go to get a flu shot ... my general physician? I don't even know where their offices are ..…

Many drug stores are doing it now. Check out Walgreen's, CVS, also Target.

Heck, my GP told me to go to one to get my Tetanus etc. booster (it's a lot easier for them to keep it in stock).

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