What We're Afraid to Say About Ebola

New York Times ^ | 9/11/2014 | MICHAEL T. OSTERHOLM

[DouglasKC]

THE Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done.

There have been more than 4,300 cases and 2,300 deaths over the past six months. Last week, the World Health Organization warned that, by early October, there may be thousands of new cases per week in Liberia, Sierra Leone, Guinea and Nigeria. What is not getting said publicly, despite briefings and discussions in the inner circles of the world’s public health agencies, is that we are in totally uncharted waters and that Mother Nature is the only force in charge of the crisis at this time.

There are two possible future chapters to this story that should keep us up at night.

The first possibility is that the Ebola virus spreads from West Africa to megacities in other regions of the developing world. This outbreak is very different from the 19 that have occurred in Africa over the past 40 years. It is much easier to control Ebola infections in isolated villages. But there has been a 300 percent increase in Africa’s population over the last four decades, much of it in large city slums. What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu — or even Karachi, Jakarta, Mexico City or Dhaka?

The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented...

[driftdiver]

Why? Roughly 50% of people don’t wash their hands after a bowel movement so we aren’t any cleaner.

Our hospitals are better but how long would that last once you have an overwhelming number of patients.

[driftdiver]

The Liberian was visiting family. He lived in Minnesota.

[cherry]

I’m still wondering why we’re even talking about Africa becauseI they’re all dead aren’t they?...I mean they were all killed off by Aids as predicted by our betters....so there can’t be any Africans to worry about now...

[PLMerite]

This is how they’ll deal with it:

https://www.youtube.com/watch?v=lO2-YxWkRxk

[Rodamala]

Why? Roughly 50% of people don’t wash their hands after a bowel movement so we aren’t any cleaner.

I don't wipe my ass like a Muslim.

[driftdiver]

Sure, doesn’t mean you don’t end up with fecal material on your hand.

I bet it makes that donut you eat afterwards taste special.

[Jim Noble]

I think Dr. Osterholm is absolutely correct that some type of incident command structure has to be put in place, and quickly.

Of course, the idea that the UN has some sort of capability along these lines is, well, a little off - but if I wanted to ring the alarm and I wanted to do it in the NYT, I might have said the same thing.

The airports and harbors in Guinea, Sierra Leone, and Liberia need to be closed, now, and only the Global Force for Good can do it. Closing Nigeria is several orders of magnitude more difficult, and the evidence in hand doesn’t show that it’s necessary (yet).

But allowing outbound flights from Monrovia, Freetown, Conakry (and probably Bamako) any more is just crazy. Within a month, you’re going to see plague ships trying to make the run to Brazil.

[silverleaf]

This female psychopath nicknamed “Lady al Qaeda” now in a US jail was carrying plans to use ebola as a bioweapon when she was arrested. That was in 2008

http://peacebenwilliams.com/ebola-used-as-terrorist-weapon-isis-demanded-release-of-female-bio-terrorist-in-exchange-for-foley/

http://www.9news.com.au/world/2014/08/22/08/28/foley-s-killers-demanded-release-of-female-terrorist

[silverleaf]

planeloads of Africans are now departing for the hajj in Mecca

what could go wrong

[silverleaf]

also spread by urine

now think about public transportation restrooms etc

[Gadsden1st]

Spend two hours in the emergency room of the largest hospital near you on a Friday or Saturday night. Then get back to me. After you have visited WalMart on your way back home, and counted the times you have touched your eyes, nose, or mouth before disinfecting them.

[palmer]

That he would publish this, at this time, and in the NYT, reflects the enormous tension that must exist today within the CDC bureaucracy.

Not really. He has published scary stories before: http://www.nyu.edu/intercep/lapietra/Osterholm_PreparingforPandemic.pdf

[txrefugee]

And Muslims from the USA will be mingling with those Africans around their rock and then will fly home to your city. That’s why those who live in small homogeneous places should give thanks. Diversity kills.

[Former Proud Canadian]

A cordon sanitaire is certainly in order immediately.

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

[Gadsden1st]

Ebola Roulette:

Abstract
A substantial portion of human respiratory tract infection is thought to be transmitted via contaminated hand contact with the mouth, eyes, and/or nostrils. Thus, a key risk factor for infection transmission should be the rate of hand contact with these areas termed target facial membranes. A study was conducted in which 10 subjects were each videotaped for 3 hr while performing office-type work in isolation from other persons. The number of contacts to the eyes, nostrils, and lips was scored during subsequent viewing of the tapes. The total contacts per subject had sample mean x = 47 and sample standard deviation s = 34. The average total contact rate per hour was 15.7. The authors developed a relatively simple algebraic model for estimating the dose of pathogens transferred to target facial membranes during a defined exposure period. The model considers the rate of pathogen transfer to the hands via contact with contaminated environmental surfaces, and the rate of pathogen loss from the hands due to pathogen die-off and transfer from the hands to environmental surfaces and to target facial membranes during touching. The estimation of infection risk due to this dose also is discussed. A hypothetical but plausible example involving influenza A virus transmission is presented to illustrate the model.
PMID: 18357546 [PubMed - indexed for MEDLINE]

[Lady Heron]

Good thing it is not airborne then.....oh wait, there is that pesky little 2012 Canadian study that sort of puts that line firmly in the bs category. Airborne now requires a Clinton explanation of I guess it depends on what the meaning of airborne is.

[Gadsden1st]

Also, males “cured” and released back into society can carry live ebola in their reproductive system for a couple of months. I am not sure they have determined how long females can carry it.

[canuck_conservative]

-Have no plan.

-Can do nothing.

-Explain the disease as nature taking its course.

Now known as "The Barack Obama Approach to Problem-Solving"

[Pecos]

With the CDC now acting its political role, I respectfully disagree. Think of the new diseases that have arrived via our southern border for which the American public has no immunity. What makes you think the administration would all of a sudden start being honest?

[voicereason]

Only true if it does not become air transmissible. Your statement works because we are better at keeping clean, which is impossible in tropical Africa. But air transmission makes that advantage worthless.

Based on information, it can be transmitted through the air if it becomes aerosolized such as through a sneeze.