First case of Ebola in the US

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RGCheek said:
Again, Ebola’s exponential growth rate and 55% mortality rate means you don’t know what you are talking about when you say there is no need for concern.
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Just because a virus grows exponentially does not mean it is spread exponentially. The cases in Dallas doubled, then quit. Please, there is not need to denigrate others that disagree with you. I high mortality rate is no more critical than rate of infection when it comes to the odds of dying.
 
RGCheek said:
Thanks for the compliment and I never stop blathering. That’s never really helped me much but its a by-product of my obsessiveness, another vice.

As to the flu being airborne, the problem is for me that various reports keep using the vernacular ‘airborne’ use that simply means it can pass through the air like with a sneeze, and the more technical definition which is that infections spreads lung to lung with dry particles capable of being suspended in the air over an indefinite period of time.

If Spanish Flu had the latter kind of contagiousness then it is the exception not the rule as I understand it. But then again I am not an authority at all, far from it. I am simply repeating what I have come to understand from reading dozens of articles, nothing more than that.
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I think we should keep blathering until we figure it out, but right now I am too tired to continue. Perhaps tomorrow. 🙂
 
Ebola Vaccine, Ready for Test, Sat on the Shelf

*GALVESTON, Tex. — Almost a decade ago, scientists from Canada and the United States reported that they had created a vaccine that was 100 percent effective in protecting monkeys against the Ebola virus. The results were published in a respected journal, and health officials called them exciting. The researchers said tests in people might start within two years, and a product could potentially be ready for licensing by 2010 or 2011.

It never happened. The vaccine sat on a shelf. Only now is it undergoing the most basic safety tests in humans — with nearly 5,000 people dead from Ebola and an epidemic raging out of control in West Africa.

Its development stalled in part because Ebola is rare, and until now, outbreaks had infected only a few hundred people at a time. But experts also acknowledge that the absence of follow-up on such a promising candidate reflects a broader failure to produce medicines and vaccines for diseases that afflict poor countries. Most drug companies have resisted spending the enormous sums needed to develop products useful mostly to countries with little ability to pay.*

mobile.nytimes.com/2014/10/24/health/without-lucrative-market-potential-ebola-vaccine-was-shelved-for-years.html?_r=2&referrer=
 
jen_fla said:
Ebola Vaccine, Ready for Test, Sat on the Shelf

*GALVESTON, Tex. — Almost a decade ago, scientists from Canada and the United States reported that they had created a vaccine that was 100 percent effective in protecting monkeys against the Ebola virus. The results were published in a respected journal, and health officials called them exciting. The researchers said tests in people might start within two years, and a product could potentially be ready for licensing by 2010 or 2011.

It never happened. The vaccine sat on a shelf. Only now is it undergoing the most basic safety tests in humans — with nearly 5,000 people dead from Ebola and an epidemic raging out of control in West Africa.

Its development stalled in part because Ebola is rare, and until now, outbreaks had infected only a few hundred people at a time. But experts also acknowledge that the absence of follow-up on such a promising candidate reflects a broader failure to produce medicines and vaccines for diseases that afflict poor countries. Most drug companies have resisted spending the enormous sums needed to develop products useful mostly to countries with little ability to pay.*

mobile.nytimes.com/2014/10/24/health/without-lucrative-market-potential-ebola-vaccine-was-shelved-for-years.html?_r=2&referrer=
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If that is so, it’s sad but hardly surprising. *Perhaps *once upon a time such research was driven by the possibility of achieving fame and/or making a difference. Now the potential to make serious bucks is a major driving factor. Which is why instead of new drugs, we often see production of very close copies of the money-making ones.
 
Nobel Prize Winner for Medicine: People Without Symptoms Or Fever May Still Spread Ebola

A study in the prestigious journal Lancet published in 2000 found that some people can carry Ebola without showing any symptoms.

The largest study on the current Ebola outbreak – sponsored by the World Health Organization – found that 13% of those infected with Ebola never had a fever.

More: washingtonsblog.com/2014/10/doctor-won-nobel-prize-work-immune-system-people-without-symptoms-fever-may-still-ebola.html

*Dr. Beutler, an American medical doctor and researcher, won the Nobel Prize for Medicine and Physiology in 2011 for his work researching the cellular subsystem of the body’s overall immune system – the part of it that defends bodies from infection by other organisms, like Ebola.

He is currently the Director of the Center for the Genetics of Host Defense at the University of Texas Southwestern Medical Center in Dallas ….

“It may not be absolutely true that those without symptoms can’t transmit the disease, because we don’t have the numbers to back that up,” said Beutler, “It could be people develop significant viremia [where viruses enter the bloodstream and gain access to the rest of the body], and become able to transmit the disease before they have a fever, even. People may have said that without symptoms you can’t transmit Ebola. I’m not sure about that being 100 percent true. There’s a lot of variation with viruses.”

In fact, in a study published online in late September by the New England Journal of Medicine and backed by the World Health Organization, 3,343 confirmed and 667 probable cases of Ebola were analyzed, and nearly 13 percent of the time, those infected with Ebola exhibited no fever at all.

Why does he think the CDC would so emphasize Ebola is not communicable in patients without symptoms?

“There’s some imperative to prevent panic among the public,” says Dr. Beutner, “But to be honest, people have not examined that with transmissibility in mind. I don’t completely trust people who’d say that as dogma.”*

Something to mull over in regards to our screening process.
 
RGCheek said:
Thank you for that informative response.

While I accept that you are saying this in all honesty and with authority, there are still two areas that concern me:
  1. Institutional incompetence like the hospital in Dallas or the feds refusal to shut direct travel to these countries and secure our ports and borders.
  2. Black Swan events.
Thank you again for your time in responding.
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Well, your first concern is a valid one. My understanding from a physician who is familiar with the events in Dallas is that the nurses requested the proper personal protection which is necessary to treat Ebola patients, and that the hospital administrators refused, citing the cost as an issue. Those nurses decided that the patient needed care, and they were willing to take risks which they should not have been required to take.

As for Black Swan events, I had to Google that term. I guess my immediate reaction is that our response should be based on evidence, and not every potential anomaly. The focus should be on eliminating the threat where it exists, which is in Africa. I read somewhere that the cost of decontaminating Duncan’s apartment was in excess of $500K. Uhmmmm… you could build an entire small apartment building for that. What a waste of money, which could have been much better spent fighting the disease.

I am discouraged by the politics which surrounds this. But I am not surprised. People are afraid. But I think that the risk of an epidemic in the US in minimal. Consider for a moment that 480,000 people die each year in the US due to smoking. How does this compare with the total Ebola fatality count? I hope that number puts recent events into perspective, as to the risk level for the average person.

Kaci (whom I know) was put into a tent in a parking lot with no heat or plumbing. That was the governor of New Jersey’s idea of quarantine. I can understand why she was upset.
 
epan said:
As for Black Swan events, I had to Google that term. I guess my immediate reaction is that our response should be based on evidence, and not every potential anomaly.
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That is not the key concept to ‘Black Swan events’. It comes from the old adage in Europe used for centuries that such-and-such wont ever happen till someone finds a black swan, similar to our time’s use of the phrase ‘when pigs can fly’. Europeans simply assumed that there was no such thing as a black swan simply because they had never seen one. Then one day they did in SE Asia about a century or two ago.

The Toxic Mortgage disaster in 3008 was based entirely on formulas that gave odds of a security losing money as one in a trillion using real estate data that only went back about 30 years, which is not nearly a large or long enough data set to make such absolute predictions about. Now there is no accepted standard way of valuing many financial securities that were based on these flawed evaluation formulas that depended on very large data sets that simply do not exist.

The idea that something cannot happen because it has never happened before or only very rarely before sets one up for a catastrophic failure if a Black Swan event does happen. For example, to say that Ebola cannot do this or that because it simply has not been proven in a lab is to set the public up for a Black Swan event.

Perhaps it adds costs and perhaps it slows some treatments down, but considering the risk if we let people act like there is no such risk makes the cost and delay worth it, IMO.
epan said:
The focus should be on eliminating the threat where it exists, which is in Africa. I read somewhere that the cost of decontaminating Duncan’s apartment was in excess of $500K. Uhmmmm… you could build an entire small apartment building for that. What a waste of money, which could have been much better spent fighting the disease.
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The use of increasing funds to fix a problem has a diminishing rate of return at some point. I don’t know the details about what expenditures can do to improve a situation significantly in a third world country like Liberia, but at some point the impact of each added dollar is diminished more and more. Some things are not fixed by adding more money. Nigeria and Senegal’s quashing of the Ebola epidemics in their countries was a great success. What did they do and how would more money help to implement that in Liberia, Sierre Leon and Guinea?

Meanwhile here in the USA we need to take steps to protect the public whatever it costs. The potential disaster’s cost far exceeds what some contractor can squeeze out of the feds. The fact is that the medical costs of doing almost anything here in the USA is initially going to be excessive until we have more firm data on the transmission of Ebola. IT has only been recently that the CDC admitted that Ebola can be spread via sneezing, but insisted that that kind of transmission requires no more than 3 feet of distance? When I read that the first thing that entered my mind was ‘They cannot know that; this is just more anti-hysteria hysteria.’
epan said:
I am discouraged by the politics which surrounds this. But I am not surprised. People are afraid. But I think that the risk of an epidemic in the US in minimal. Consider for a moment that 480,000 people die each year in the US due to smoking. How does this compare with the total Ebola fatality count? I hope that number puts recent events into perspective, as to the risk level for the average person.
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Yeah, parties now gear up for the next election before its clear who all the winners and losers were in the current election. Everything today is political in one fashion or another.
epan said:
Kaci (whom I know) was put into a tent in a parking lot with no heat or plumbing. That was the governor of New Jersey’s idea of quarantine. I can understand why she was upset.
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Well, that is Governor Christy for you. Just note that he has never been famous for his sensitivity and charm.

I would think that if you are going to force people into quarantine that you would make sure that they were completely comfortable so that they wouldn’t avoid it so much. And make sure they still get their customary wages as well.
 
RGCheek said:
That is not the key concept to ‘Black Swan events’. It comes from the old adage in Europe used for centuries that such-and-such wont ever happen till someone finds a black swan, similar to our time’s use of the phrase ‘when pigs can fly’. Europeans simply assumed that there was no such thing as a black swan simply because they had never seen one. Then one day they did in SE Asia about a century or two ago.

The Toxic Mortgage disaster in 3008 was based entirely on formulas that gave odds of a security losing money as one in a trillion using real estate data that only went back about 30 years, which is not nearly a large or long enough data set to make such absolute predictions about. Now there is no accepted standard way of valuing many financial securities that were based on these flawed evaluation formulas that depended on very large data sets that simply do not exist.

The idea that something cannot happen because it has never happened before or only very rarely before sets one up for a catastrophic failure if a Black Swan event does happen. For example, to say that Ebola cannot do this or that because it simply has not been proven in a lab is to set the public up for a Black Swan event.

Perhaps it adds costs and perhaps it slows some treatments down, but considering the risk if we let people act like there is no such risk makes the cost and delay worth it, IMO.

The use of increasing funds to fix a problem has a diminishing rate of return at some point. I don’t know the details about what expenditures can do to improve a situation significantly in a third world country like Liberia, but at some point the impact of each added dollar is diminished more and more. Some things are not fixed by adding more money. Nigeria and Senegal’s quashing of the Ebola epidemics in their countries was a great success. What did they do and how would more money help to implement that in Liberia, Sierre Leon and Guinea?

Meanwhile here in the USA we need to take steps to protect the public whatever it costs. The potential disaster’s cost far exceeds what some contractor can squeeze out of the feds. The fact is that the medical costs of doing almost anything here in the USA is initially going to be excessive until we have more firm data on the transmission of Ebola. IT has only been recently that the CDC admitted that Ebola can be spread via sneezing, but insisted that that kind of transmission requires no more than 3 feet of distance? When I read that the first thing that entered my mind was ‘They cannot know that; this is just more anti-hysteria hysteria.’

Yeah, parties now gear up for the next election before its clear who all the winners and losers were in the current election. Everything today is political in one fashion or another.

Well, that is Governor Christy for you. Just note that he has never been famous for his sensitivity and charm.

I would think that if you are going to force people into quarantine that you would make sure that they were completely comfortable so that they wouldn’t avoid it so much. And make sure they still get their customary wages as well.
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Ebola spreads slowly, and therefore is not a big threat to the US. I do have some expertise, based on experience. There is no need to panic. Please support efforts to get things under control in Africa.
 
epan said:
Ebola spreads slowly, and therefore is not a big threat to the US. I do have some expertise, based on experience. There is no need to panic. Please support efforts to get things under control in Africa.
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See my link above; Ebola cases are doubling every 3-4 weeks, or at least were. It seems the number of cases has dropped in Liberia, a huge win for the good guys.
 
RGCheek said:
See my link above; Ebola cases are doubling every 3-4 weeks, or at least were. It seems the number of cases has dropped in Liberia, a huge win for the good guys.
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Conditions are very different here than in the US. If your point is that Ebola could spread at that rate in the US, I would point out that it would not because the sanitary conditions, living conditions, customs, and healthcare resources are vastly different.
 
epan said:
Conditions are very different here than in the US. If your point is that Ebola could spread at that rate in the US, I would point out that it would not because the sanitary conditions, living conditions, customs, and healthcare resources are vastly different.
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I don’t think you get the point.

While top line hospitals do manage Ebola well, the Dallas hospital illustrates how ill prepared/trained most hospitals really are.

As to spreading in the US, how many people really wash their hands as often as they should? People in the USA sneeze all over their vicinity all the time without blocking it hardly at all. While transmission of Ebola is low until a week or so before death, there are large demographic niches that do not like reporting to hospitals or any other establishment facility and always try to self medicate; I know a few.

At $500,000 per person costs to clean up and decontaminate, how may cases will be required to collapse our health care system? I don’t think it will take more than a couple of thousand cases to bankrupt medical insurance companies and then the public hospitals.

No offense, but I think you are being presumptive and succumbing to hubris on this specific issue.
 
RGCheek said:
I don’t think you get the point.

While top line hospitals do manage Ebola well, the Dallas hospital illustrates how ill prepared/trained most hospitals really are.

As to spreading in the US, how many people really wash their hands as often as they should? People in the USA sneeze all over their vicinity all the time without blocking it hardly at all. While transmission of Ebola is low until a week or so before death, there are large demographic niches that do not like reporting to hospitals or any other establishment facility and always try to self medicate; I know a few.

At $500,000 per person costs to clean up and decontaminate, how may cases will be required to collapse our health care system? I don’t think it will take more than a couple of thousand cases to bankrupt medical insurance companies and then the public hospitals.

No offense, but I think you are being presumptive and succumbing to hubris on this specific issue.
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I have treated hundreds of EVB cases. I am not offended by your comments. I think you are overreacting.
 
epan said:
Consider for a moment that 480,000 people die each year in the US due to smoking. How does this compare with the total Ebola fatality count? I hope that number puts recent events into perspective, as to the risk level for the average person.

Kaci (whom I know) was put into a tent in a parking lot with no heat or plumbing. That was the governor of New Jersey’s idea of quarantine. I can understand why she was upset.
Click to expand...
Now that’s comparing cows to oranges! (Cigarets to Ebola)😃
Smokers have decades to come to terms with their fate (vs 21 days); cigarette smoke is not instantly damaging (21 days) to those near by; cigarette smoke will not prompt hundreds of thousands of wedding gowns to be destroyed; lastly, smokers have been warned how they can quit smoking to long-gate their survival.

Ebola is scary, and we should have a healthy fear toward it. Failure to head to this fear is disrespecting the immediate threat this disease can have on a civilization. Several of your posts say, “trust me”, but somehow, something with Ebola seems far more reaching than any government/organization can contain.
 
I certainly hope the Nebraska patient can pull through, I think they say he or she is a doctor and this patient was taken in sicker than any of the others. He/She came in from Sierra Leone.
 
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