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

nytimes.com

51–60 of 110 posts

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

#51

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.

Malaria kills over half a million people a year, out of over 200M cases. Why is ebola so much more alarming?

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

#52
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…

> "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."

She apparently died several hours later. If that is true, then while he was interacting with her she was extremely symptomatic. We're talking bleeding out of everywhere. Ebola is not a subtle disease, and she was not merely exhibiting flu-like symptoms at that point. Furthermore, the hospital turned her away because their ebola ward was full.

While it is possible that he was an idiot who believed the claims that it was simply pregnancy complications, we're deep into "sufficiently advanced incompetence is indistinguishable from malice" territory. And frankly, it is more charitable to Duncan to assume that he lied. Better a liar than an idiot of that magnitude.

http://en.wikipedia.org/wiki/Thomas_Eric_Duncan#Timeline_of_...

> "On September 15, 2014, the family of Ebola virus disease patient Marthalene Williams were unable to summon an ambulance to transfer Williams to the hospital. Their tenant, Duncan, helped to transfer Williams by taxi to an Ebola treatment ward in Monrovia, Liberia. Duncan rode in the taxi to the treatment ward with Williams, her father, and her brother. The family was turned away due to lack of space and Duncan helped carry Williams from the taxi back into her home, where she died shortly afterwards.[11]"

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

#53

Earlier quoted context omitted.

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 vira…

http://en.wikipedia.org/wiki/History_of_syphilis

"The first well-recorded European outbreak of what is now known as syphilis occurred in 1495 among French troops besieging Naples, Italy.[3] From this centre, the disease swept across Europe. As Jared Diamond describes it, "[W]hen syphilis was first definitely recorded in Europe in 1495, its pustules often covered the body from the head to the knees, caused flesh to fall from people's faces, and led to death within a few months." The disease then was much more lethal than it is today. Diamond concludes,"[B]y 1546, the disease had evolved into the disease with the symptoms so well known to us today."

It doesn't take millions of years for diseases to adapt.

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

#54
post #52

Earlier quoted context omitted.

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…

> "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." She apparently died several hours later. If that is true, then while he was interacting with her she was extremely symptomatic. We're talking bleeding out of everywhere. Ebola is not a subtle disease, and she was not m…

Most Ebola patients never bleed profusely the way we imagine them to (though, as it happened, this particular woman was bleeding from the mouth). It apparently is actually very hard to distinguish from other tropical diseases in most cases. http://www.who.int/mediacentre/factsheets/fs103/en/

In fact, that is why it took so long to identify and respond to the current outbreak.

>Here, then, still in January, long before the outbreak took off, a team of doctors stood at ground zero, staring at some of the first casualties. They had no idea what they were looking at.

> The way Ebola kills would seem impossible to mistake. What the casual observer knows of Ebola are its most spectacular cases, or the cinematic depictions of them: prodigious bleeding from eyes, ears, nose, anus, and nipples. Symptoms like these, presenting all at once, would be impossible to miss or misinterpret. But not every Ebola case ends with such a biblical scourge, and many of Ebola’s symptoms are identical to those brought on by other diseases. Until its final stages, Ebola can easily be mistaken for cholera. It can also look a lot like malaria, another long-tenured killer in Guinea.

http://www.vanityfair.com/politics/2014/10/ebola-virus-epide...

I don't know why it's so hard to believe that the woman's parents, in denial, said that she was merely suffering from serious complications from her pregnancy and he believed them. It's not as though he would have conducted a thorough exam. He just helped the family carry her a short distance.

And, I should add, the very fact that he did this is probably the best evidence there could be that he did not know she had ebola.

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

#55

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.

Malaria kills over half a million people a year, out of over 200M cases. Why is ebola so much more alarming?

A few reasons.

1) Because malaria is 'over there' and ebola is threatening to come 'over here.'

2) Ebola has been hyper sensationalized, and is not as well understood as malaria.

3) Ebola has a very high mortality rate, with an almost coin-flip chance of surviving it.

4) The world has been dealing with malaria for a very long time. Ebola is new on the block. It seems any new virus tends to make waves these days, from SARS to West Nile.

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

#57

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.

Malaria kills over half a million people a year, out of over 200M cases. Why is ebola so much more alarming?

You pretty much answered your own question- .5M deaths out of 200M. Ebola kills 50-90%

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

#58
post #47

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 ..…

I relate. I usually don't get one either for equally poor reasons. But these days they make it really easy: you can get one from CVS, Walgreens, Rite Aid, and other pharmacy chains.

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

#59

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…

My total layman's impression of this has been that it doesn't matter if the virus mutates to something "worse" -- that, short of some currently politically impossible action several orders of magnitude beyond what is currently being done, there is no really solid, non-magical-thinking, reason to believe this outbreak won't kill tens/hundreds of millions of people and threaten world civilization as we know it, even with the virus as it currently is.

The way the narrative has shifted in the past week has done a really good job of discrediting any routes to denial I'd previously had.

I would love to hear some credibly informed people disabuse me of this notion, in some way beyond calling my impressions those of an ignorant, panicky fool.

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

#60
post #52

Earlier quoted context omitted.

> "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." She apparently died several hours later. If that is true, then while he was interacting with her she was extremely symptomatic. We're talking bleeding out of everywhere. Ebola is not a subtle disease, and she was not m…

Most Ebola patients never bleed profusely the way we imagine them to (though, as it happened, this particular woman was bleeding from the mouth). It apparently is actually very hard to distinguish from other tropical diseases in most cases. http://www.who.int/mediacentre/factsheets/fs103/en/ In fact, that is why it took so long to identify and respond to the current outbreak. >Here, then, still in January, long befor…

Regardless, in this particular case it seems rather apparent that Duncan lied. If she was bleeding from the mouth and he was aware of it, in Liberia during an Ebola outbreak, then there at the very least he should have answered that "history of contact with ebola" question with a strong "maybe".

I am suspicious of the family being in denial, but I don't think that it is impossible. However for Duncan to also be in denial is far less probable.

It also should be noted that "I thought she had cholera/malaria" and "I thought she was having complications with her pregnancy" are two rather distinct claims. Had he said "I don't think that I had contact with ebola, but I did interact with somebody who seemed to have cholera recently..." then I would be far less critical.

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