While not our usual fare, I provide this guest essay for discussion without comment, as it is concerned with an issue of great interest and impact to millions of people – Anthony
Guest essay by Alec Rawls
Negative atmospheric pressure sounds climate related, but it is just an analogy to the inward draw of air that contagious disease laboratories and isolation rooms use to keep pathogens from escaping. The only way to make it safer for Ebola hot-zone residents to stay put and keep the current epidemic from spreading is to use immune survivors to separate and treat the sick, a strategy developed by the Greeks 2400 years ago, but our national policies are working ever more powerfully in the opposite direction, creating strong incentives for infected and possibly infected people to flee to the United States from Liberia, Guinea and Sierra Leone. Given this rapidly changing climate of contagion, and the importance of bringing the Greek solution to the national consciousness, I asked Anthony to please let me publish this post in his broader “puzzling things” category.
An example of something that creates an undesirable “positive atmospheric pressure” in the Ebola hot-zone is the promise that CDC Director Tom Frieden issued last week, telling the world that if anyone arrives at a major American airport with history or symptoms that indicate possible Ebola infection they will be whisked straight to the hospital, providing the strongest possible incentive for people who think they might be infected to come here for treatment. (This incentive can also be described as the creation of negative atmospheric pressure in the United States because the flux direction depends on position.)
At the same time, Frieden insists that travel from Liberia, Guinea and Sierra Leone to the United States should remain unrestricted, providing opportunity as well as incentive for hot-zone residents to flee here. From Frieden’s October 9th interview on Fox News:
Staff from CDC and the Department of Homeland Security’s Customers & Border Protection will begin new layers of entry screening, first at John F. Kennedy International Airport in New York this Saturday, and in the following week at four additional airports … [which] … receive almost 95 percent of the American-bound travelers from the Ebola-affected countries.
Travelers from those countries will be escorted to an area of the airport set aside for screening. There they will be observed for signs of illness, asked a series of health and exposure questions, and given information on Ebola and information on monitoring themselves for symptoms for 21 days. Their temperature will be checked, and if there’s any concern about their health, they’ll be referred to the local public health authority for further evaluation or monitoring.
This funneling of hot-zone travelers through screening here in the U.S. was just made mandatory, guaranteeing care to the possibly infected. The resulting outward pressure—motivating infected people to move to a previously uninfected continent—will spread the infection, not contain it. Set aside that the CDC is supposed to give priority to American lives and should first and foremost work to keep Ebola from coming here, intercontinental spread of Ebola is a disaster for the whole world. Each breach of containment endangers everyone everywhere.
Not making obvious mistakes like this is the easy part (or should be), but creating “negative atmospheric pressure” in the hot-zone is not so easy. It has to be safer for residents of the hot-zone to stay put than to leave. That means that transmission within the hot-zone has to be stopped or greatly reduced.
So long as the contagion keeps expanding within the hot-zone itself the pressure on residents to flee will keep increasing. But fighting transmission inside the hot zone is a labor intensive enterprise. Health care workers have to first diagnose who is infected and who is not, then isolate and treat the sick, all of which presents a high risk of transmission to the people doing this work. So how can transmission be stopped?
The only people who can fight Ebola on the ground without becoming vectors of transmission themselves are the immune survivors
Ebola is perhaps the most infectious pathogen ever encountered, transmissible by a single particle. The repeated assurances that Ebola is not highly contagious apply only while patients remain asymptomatic. Once they start explosively erupting at both ends, protection for anyone in attendance must be perfect, which is very difficult to achieve. Sixteen members of Doctors Without Borders have become Infected and these are the best trained and equipped people in Africa. The numbers are vastly higher for the less well trained and equipped native African health care workers.
Three weeks ago NPR ran a happy talk segment on how easy it is to stop the spread of Ebola that completely ignored the problem of transmission through health care workers:
So to stop the chain of transmission, all health workers in Texas have to do is get the people possibly infected by the sick man into isolation before these people show signs of Ebola.
Then R0 drops to zero. And Texas is free of Ebola.
Then we all found out how difficult it is to keep health workers from getting the disease. The transmission rate, R-zero, does not drop to zero. With enough training and equipment transmission might be lowered dramatically, but only at impossible cost. Here a hospital director reacts to the CDC’s prep call (via Brian Preston):
Ebola Preparation “will bankrupt my hospital!” “Treating one Ebola patient requires, full time, 20 medical staff. Mostly ICU (intensive care unit) people. So that would wipe out an ICU in an average-sized hospital.”
At extreme expense we might be able to protect medical workers from contamination in a very limited number of Ebola cases. In Africa, forget it. But immune survivors do not need to be protected from contamination and this is a resource that Africa has in rapidly growing numbers.
Immune survivors can make it both safer and more remunerative for hot-zone residents to stay put
Survivors have full immunity only to the Ebola strain they were infected with, but if they provide care in their local area they should be okay. Dr. Bruce Ribner on PBS:
Ebola virus is a new infection on this continent, but our colleagues across the ocean have been dealing with it for 40 years now, and so there is strong epidemiologic evidence that, once an individual has resolved Ebola virus infection, they are immune to that strain, recognizing that there are five different strains of Ebola virus.
Designate local isolation compounds for triage and treatment, drop off people and supplies, and no one comes out without a clean bill of health, bleached clothes, and a nice chlorinated shower. The immunity (in most cases) of the survivors means they could provide care without transmitting the disease, allowing the contagion to be rolled back, and the income they receive (this is where aid money comes in) would prop up the local economy, all of which would work to keep hot-zone residents in place.
If coming to America is off the table then flight from the Ebola hot-zones is a very daunting proposition. Africa is not a thriving land of opportunity and travel is more of a way to catch disease than avoid it. Thus if transmission within the hot-zone can be drastically reduced, negative atmospheric pressure is readily attainable, and this is what the use of immune survivors allows. Not being vectors, they can intercede to stop transmission in the cases under their care.
Some of these survivor health-workers will get infected with different strains and some will surely die from it, but the fact that they are largely immune will allow the work of isolation and treatment to continue, which is simply not possible otherwise on any major scale.
Six weeks ago I started writing on my own blog the about the need to focus on an immune survivor strategy. Since I only post intermittently nobody sees my stuff unless I post elsewhere (thanks Anthony), but I did send my post to Stanford health economist Jay Bhattacharya and he said hey, that’s Thucidydes!
The immune-survivor treatment strategy was implemented by the Greeks 2400 years ago
Jay sent me this passage from Thucydides:
But whatever instances there may have been of such devotion, more often the sick and the dying were tended by the pitying care of those who had recovered, because they knew the course of the disease and were themselves free from apprehension. For no one was ever attacked a second time, or not with a fatal result. All men congratulated them, and they themselves, in the excess of their joy at the moment, had an innocent fancy that they could not die of any other sickness.
Neither am I the only one to advocate the use of immune survivors today. The day after I published my post Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, wrote the following in The New York Times:
The United Nations … should also coordinate the recruitment and training around the world of medical and nursing staff, in particular by bringing in local residents who have survived Ebola, and are no longer at risk of infection.
We have one immune survivor here in the United States, Dr. Kent Brantly, and with luck and prayers he may soon be joined by Nina Pham and Amber Vinson, but West Africa has a few thousand, and with the infection rate expected to soon reach 10,000 per week, that will become another 3000 survivors a week. The resource is there, we just have to use it, but the rationalizations provided by CDC Director Frieden show that he is looking in the opposite direction.
Frieden wants non-immune aid workers to go to Africa
That’s what he keeps saying whenever he tries to explain why he is against travel restrictions, that restrictions will make it harder for aid workers to travel to Africa:
One strategy that won’t stop this epidemic is isolating affected countries or sealing borders. When countries are isolated, it is harder to get medical supplies and personnel deployed to stop the spread of Ebola.
As the likely author of whatever restrictions would be imposed, Frieden would be free to attach whatever exceptions he deems necessary for getting aid workers in and out, but set that aside. His premise to begin with is that outsiders should be going in and providing treatment. Like the happy talkers at NPR (who were trying to explain why Frieden is so confident that Ebola will not spread in the United States), Frieden ignores the problem of health care workers as a disease vector. About people who are being tracked and monitored he says:
The moment if they have any symptoms, if they have fever, they will be isolated. That is how you break the chain of transmission.
Yeah, not really. For a very small number of Ebola patients, at huge expense, maybe, if levels of protection and training are vastly improved. For Africa? Send in supplies and a small number of organizers at most, but no one from the outside should be sent in to deal with possibly infected subjects, not our military, not the National Guard, and unexposed natives should not be recruited either. Turn it over to the immune survivors. That is the only way to stop the contagion, and this critical resource is not here in America. It only exists in Africa, so stop bringing Ebola patients here!
Frieden keeps insisting that efforts to contain Ebola geographically will cause it to spread geographically
It is a bizarre contention. All non-government commentators regard isolation and treatment as complimentary strategies but Frieden insists they are either/or:
Restricting travel or trade to and from a community makes it harder to control in the isolated area, eventually putting the rest of the country at even greater risk. Isolating communities also increases people’s distrust of government, making them less likely to co-operate to help stop the spread of Ebola.
He is equating isolation with abandonment, which is a non sequitur. Does a patient placed in an isolation room become harder to control? Does being cared for in isolation make him more distrustful, and make observers distrustful, or does it make every one thankful? Frieden’s strained efforts to support this weak narrative are illogical to the point of dishonesty:
When a wildfire breaks out we don’t fence it off. We go in to extinguish it before one of the random sparks sets off another outbreak somewhere else.
Really, the guy’s never heard of a firebreak? We actually set fires, sacrificing part of the tree population to save the rest. Not that we should do that in Africa, but c’mon dude. Don’t just lie about stuff!
Travel restrictions may indeed have some downsides, but they also have a most important upside: they stop sick people from traveling around the world spreading disease. The question, which Frieden never even attempts to address, is whether the downsides he puts forward outweigh the upside in terms of disease transmission. Indeed, it is perfectly clear that Frieden is not accounting the upside at all, since he implicitly assumes it would be outweighed by the flimsiest of hypothesized downsides.
In reality, it is hard to think of any downside to travel restrictions that could begin to compare to the importance of keeping the Ebola-infected from freely carrying the disease wherever they want. The first imperative is to stop Ebola from making its way around the world and as director of the CDC it is Frieden’s first responsibility to make sure it doesn’t travel here. If other countries are also self-protective that is good. It will limit the spread of Ebola which makes everyone safer.
Is Frieden (and/or Obama) trying to reduce outward pressure by holing the containment vessel?
As meteorologists know, atmospheric pressure can be a tricky concept. Because it pushes in different places, distinguishing cause and effect can take some care, and this applies to the disease transmission analogy as well.
To achieve negative pressure in the Ebola hot-zone containment is obviously not enough. Transmission within the hot zone must be greatly reduced or else pressure to flee will build and build until it inevitably explodes. Could Frieden be looking at this looming build-up of pressure and getting the causality backwards? Is he proceeding on the idea that, if we never have containment in the first place, then the pressure cannot build enough to have an explosion?
Actions suggest that he and others may actually be trying to reduce outward pressure by getting rid of containment up front and even encouraging people to flee. Witness the “Ebola Outbreak-related Immigration Relief Measures” issued by the U.S. immigration service in mid-August, which the CDC would surely have had input on. Some of the measures are reasonable, allowing “Nationals of Guinea, Liberia and Sierra Leone Currently in the United States” to stay here for now instead of forcing them to go back to the hot zone when their visas expire, but the measures gratuitously go much further, providing extreme incentive for residents of these countries to get themselves into the United States ASAP.
The really damaging relief measure (pressure relief measure?) is the first, which offers an opportunity for, “[c]hange or extension of nonimmigrant status for an individual currently in the United States, even if the request is filed after the authorized period of admission has expired.”
A change of status means a change from non-immigrant to immigrant status, thus any West African who is here on a tourist visa is eligible to be immediately switched to permanent resident status, leading to citizenship, and here’s the kicker: as Doug Ross noticed, there is no cut-off date for who is eligible for this change of status.
Instead of applying only to West Africans who were already here in mid-August, any Ebola-zone citizens who can get themselves over here on a tourist visa are immediately eligible to switch to permanent resident status, providing huge incentive for immediate mass outflow from West Africa to the United States. Obama/Frieden are offering them a once-in-a-lifetime jump-to-the-head-of-the-line opportunity to become American citizens.
We know Obama’s motivation, but why is the CDC going along?
President Obama, being a politician, can of course have political motivations for incentivizing West Africans to come here for citizenship. His intentional collapse of our southern border suggests that one of the ways that he wants to “fundamentally transform America” is by importing a new electorate, more to his liking. (DHS let a huge contract for the internal transport of unaccompanied illegal alien minors months before the vast wave of “unaccompanied minors” arrived, proving that the entire crisis was engineered by Obama.)
But CDC Director Frieden is supposed to be non-partisan, guided only by the objective requirements for keeping his countrymen safe from disease. How can a medical doctor be supportive of a ramped-up influx of immigrants from West Africa that is highly incentivized to carry Ebola?
Friedan’s big career-making achievement was dramatic reductions of tuberculosis in New York City and India, accomplished by systematic tracking, isolation and treatment of the infected. His oft-repeated mantra on Ebola is the same. “We know how to stop Ebola,” he says, by tracking, isolating, and treating infected individuals. Could he be fixated on tracking as a means?
Frieden wants people who could be infected with Ebola to fly so that they won’t travel “over land”
Note the particular language Frieden uses to explain why he thinks travel restrictions will be counter-productive. He keeps saying he wants the possibly infected to travel by means that enable tracking. That points directly to a preference for airline travel:
FRIEDEN: Right now, we know who’s coming in. If we try to eliminate travel, the possibility that some will travel over land, will come from other places, and we don’t know that they’re coming in, will mean that we won’t be able to do multiple things. … Borders can be porous — may I finish? – especially in this part of the world. We won’t be able to check them for fever when they leave, we won’t be able to check them for fever when they arrive. We won’t be able, as we do currently, to take a detailed history to see if they were exposed when they arrive.
When they arrive, we wouldn’t be able to impose (ph) quarantine as we now can if they have high-risk contact. We wouldn’t be able to obtain detailed locating information, which we do now, including not only name and date of birth, but e-mail addresses, cell phone numbers, address, addresses of friends, so that we could identify and locate them.
We wouldn’t be able to provide all of that information, as we do now, to state and local health departments, so that they can monitor them under supervision. We wouldn’t be able to impose controlled release, conditional release on them, or active monitoring, if they’re exposed, or to, in other ways…
The whole point of tracking is to stop further transmission so that we don’t have to do more tracking. The fact that a mode of travel enables tracking isn’t a plus if it also multiplies the need to track, as around the world commercial jet travel obviously does. In Frieden’s accounting the smallest amount of un-tracked contagion is more dangerous than a wide open and highly incentivized avenue of tracked contagion, because this is what we are talking about here.
The “overland” spread of Ebola that is Frieden’s sole concern would be extremely difficult under a travel ban. Even if frightened people could make their way out of Liberia and Guinea and Sierra Leone by ground travel (very difficult, snce many neighboring countries have closed their borders) they would still need to fly to reach the United States, which requires a visa, which requires a passport, which would still identify them as coming from a hot-zone country. The other possibility is that they fly to Mexico or Canada and travel overland at this end, but a) these crossings are within in our power to control, and b) if we impose a travel ban then Mexico and Canada will surely follow suit.
Frieden focuses entirely on the relatively tiny number of cases where a few West Africans might still get in by these untracked routes (a number that might well be decreased, not increased, by travel restrictions), and he completely ignores ignores the vast majority of cases where travel restrictions would keep the possibly Ebola-infected out. This selective accounting is not legitimate. It is basic economics and basic epidemiology that all impacts have to be fully accounted. Only looking at untracked flow is like buying merchandise for $100 a pop, selling it for $1 a pop, and thinking you are making money because you are only counting the flow of $1 receipts.
NIAID head directly mis-states travel requirements
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, does not seem to be aware of how travel documentation works. On Sunday he claimed that:
“If you say, ‘Nobody comes in from Sierra Leone, Liberia or Guinea,’ there are so many other ways to get into the country. You can go to one of the other countries and then get back in [to the United States]. So when they come in from a place where you know you can track them, you know [where they are].”
Wrong. Escapees from the hot-zone would only be able to get here via “other countries” if those other countries start issuing them passports that hide their true origin. Frieden and Fauci are doctors, not travel agents, but the entire USCIS knows that their claim about border hoppers being able to fly to the United States is wrong.
Regardless of Fauci’s confusion, the underlying error is still the same. Even if travel restrictions did somehow lead to an increase in un-tracked travel across the Atlantic (highly dubious), this increased avenue for Ebola transmission would still be tiny compared to the vast wide-open “above ground” highway for Ebola transmission that a travel ban would close off.
These supposed experts are acting as if there is no danger so long as we can track transmission, ignoring what a desperate game it is try to smother every outracing tendril from each outbreak. It’s like trying to stamp out an intrusion of cockroaches before any can escape through a crack.
Learning the wrong lesson from Nigeria’s close call
With heroic effort Nigeria just pulled off the squash-all-the-cockroaches feat, dedicating thousands of man hours of urgent detective work to successfully run down and isolate each multiplying pathway of Ebola exposure before they could multiply out of reach and consume a city of 21 million.
It was a very near thing and Frieden and Fauci are clearly learning the wrong lesson from it. They view it as confirmation that tracking works and can “stop Ebola in its tracks,” but the real lesson of Nigeria is the tremendous danger that just one infected airline passenger can pose. Realizing how lucky they were, Nigeria learned its lesson and stopped its hot-zone flights.
Much better not to let possibly infected people enter in the first place. Once an Ebola-infected person arrives a country might be quick enough to stop the contagion by tracking, monitoring and isolating individuals, but if the contagion gets away from them they will have to stop it the old fashioned way, the Greek way, by making use of the immune survivors as they emerge one by one from the spreading catastrophe.
Every nation has to be prepared for those same three stages of Ebola prevention and response. First we try to keep it from entering. If that fails then we try to contain the outbreak with tracking, monitoring and isolation of exposed individuals, and if that fails and there is an epidemic, only immune survivors can roll it back. Frieden and Fauci are fixated only on the middle third of this puzzle, the tracking. They aren’t concerned with keeping Ebola from getting here and they aren’t looking at how to fight it if it breaks out. Neither are they merely absent from these other battlefields but their fixation on tracking has them aggressively bringing Ebola here (losing the first battle), when the only people who can safely treat the disease are in Africa (losing the final battle).
A perfect storm of illogic
Put Frieden’s apparent belief that tracking is a panacea together with his apparent confusion about cause and effect and they support each other. This seems to be his actual thinking: that if we let the infected out of the hot zone (while carefully tracking) then there won’t be an explosion because the pressure won’t have a chance to build up.
Could it be that simple, that he just doesn’t understand atmospheric pressure, where the whole point of creating negative pressure is to stop the outflow of the pathogen, so if pressure is reduced by the outflow of the pathogen that means we failed? Is the guy just that stupid? Or does he have some horrific political agenda like President Obama? (Definitely possible, since untracked TB and other infectious diseases pouring over our unenforced southern border elicit no protest from him.)
Either way, Congress better provide some countervailing force and quickly because the CDC is working hard to bring the negative pressure to our side of the Atlantic, sucking Ebola in. It is clear what we should be doing: imposing travel restrictions and using hot-zone Ebola survivors to separate and treat the newly infected. Then the problem won’t just stay in West Africa, it will be solved there.
The alternative, if Obama and Frieden can’t be stopped, is that we suffer our own Ebola epidemic, where the only way to avoid decimation or worse will be to deploy our own rapidly growing army of immune survivors. It’s either Thucydides in Africa or Thucydides in America, our choice.
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What is interesting to me is that the simple concept of quarantine is well understood and accepted as a best practice. Restricting flights out of a hot zone is nothing more than a form of quarantine and yet it is immediately subject to the illogical and flawed thought processes that accompany political correctness wherever it is found.
How is it that as increased critical responsibility is assigned to an elite few at the top of the command chain the sensibilities of those few are immediately made suspect and worrisome by their hasty adoption of political correctness? Is it more important to sound correct rather than to be correct? This scenario plays out all through the leftosphere of progressive ignorance. It can’t be chance.
Excellent article. And dp’s comment above is worth noting.
The actions of this Administration are criminal, nothing less. If you or a family member is killed by this deadly disease because any west African who catches it has been invited to freely immigrate to this country for treatment at taxpayer expense, then whose fault would that be?
The most basic duty of the President is to protect American citizens. He is deliberately shirking that duty. Innocent people will die as a direct result.
As other have said, we get a chance to vote next month. Use it!
“As other have said, we get a chance to vote next month. Use it!”
I hope we can continue that tradition too. Could his third term be under Marshall Law?
http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php
INFECTIOUS DOSE: Viral hemorrhagic fevers have an infectious dose of 1 – 10 organisms by aerosol in non-human primates. Emory Univ. found viral load in a 1.5th of a teaspoon of blood 10 Billion virus vs only 50K for HIV or 200,000 times the virus. This makes the virus a Bio-Hazard level 4.
COMMUNICABILITY: Communicable as long as blood, body fluids or organs, contain the virus. Ebolavirus has been isolated from semen 61 to 82 days after the onset of illness, and transmission through semen has occurred 7 weeks after clinical recovery
In epidemiology, you measure the “R0,” or “reproduction number” of a virus; When R0 is greater than 1, the virus is spreading through a population. September the WHO’s Ebola Response Team estimated the R0 to be at 1.71 in Guinea and 2.02 in Sierra Leone. WHO estimated that by October 20, there would be 3,000 total cases in Guinea, Liberia, and Sierra Leone. As of October 7, the count was 8,376 Thus far; CDC officials have insisted that it will be different in America. On September 30, CDC director Thomas Frieden confirmed the first case of Ebola in the United States, the aforementioned Thomas Duncan. Frieden then declared, “We will stop Ebola in its tracks in the U.S. Because despite the fact that Duncan was a lone man under scrupulous, first-world care, with the eyes of the entire nation on him, his R0 was 2, just like that of your average Liberian Ebola victim; one carrier; two infections.
CONTAINMENT REQUIREMENTS: Containment Level 4 facilities, equipment, and operational practices for work involving infectious or potentially infectious materials, animals, and cultures.
OTHER PRECAUTIONS: All activities with infectious material should be conducted in a biological safety cabinet (BSC) in combination with a positive pressure suit, or within a class III BSC line. Centrifugation of infected materials must be carried out in closed containers placed in sealed safety cups, or in rotors that are unloaded in a biological safety cabinet. The integrity of positive pressure suits must be routinely checked for leaks. The use of needles, syringes, and other sharp objects should be strictly limited. Open wounds, cuts, scratches, and grazes should be covered with waterproof dressings.
Transmission of Ebola virus from pigs to non-human primates
Piglets inoculated oro-nasally with ZEBOV were transferred to the room housing macaques in an open inaccessible cage system. All macaques became infected.
http://www.nature.com/srep/2012/121115/srep00811/full/srep00811.html
http://healthmap.org/site/diseasedaily/article/pigs-monkeys-ebola-goes-airborne-112112
Dr. David Sanders, an associate professor of biological sciences at Purdue University, warned that Ebola could undergo mutations that would make it an airborne virus.
http://www.breitbart.com/Breitbart-TV/2014/10/13/Expert-Ebola-Primed-to-Go-Airborne
Ebola could infect 1.4 million people by January How bad could the Ebola outbreak get? There are lots of predictions floating around. The World Health Organization; projects that 20,000 people will be infected in November. HeathMap, put the number at about 14,000 if there’s no improvement in the situation. But in worst-case scenario, the Centers for Disease Control and Prevention project that up to 1.4 million people could be infected by January. The worst-case scenario envisioned by the model is anywhere from 537,000 to 1,367,000 cases by January; just in Liberia; with the fever still raging out of control.
Health-care staffs fear for their lives. To date, more than 170 health-care workers have been infected and at least 81 have died. By the by, that Science article written by 58 medical professionals tracing the emergence of Ebola—5 of them died from Ebola before it was published.
The maximum incubation period is 21 days. False. The 21-day period represents a statistical boundary during which 95% of infections will be detected. Actual occurrences of infection have been observed at over 40 days (twice the 21-day interval) after initial exposure.
http://www.americanthinker.com/2014/10/ebola_and_the_centers_for_dissimulation_and_confusion.html#ixzz3GgC2Q0h6
Ebola virus is present only in bodily fluids. False. Viable and infectious Ebola virus may persist on surfaces, depending upon temperature, humidity, and pH, for up to 2 days. Yet what’s really scary is how robust the already-established transmission mechanisms are. Have you ever wondered why Ebola protocols call for washing down infected surfaces with chlorine? Because the virus can survive for up to three weeks on a dry surface.
Dogs can catch Ebola. True. Dogs that have been exposed to Ebola virus can become infected but usually do not become ill and can shed virus.
Do you really want to be scared? What’s to stop a jihadist from going to Liberia, getting himself infected, and then flying to New York and riding the subway until he keels over?
My concern with this is, how many survivors become long term carriers?
We have already seen sad cases of survivors infecting their spouses, because their bodies continue to produce virus particles for many weeks after recovery.
So is it such a stretch to worry some survivors might stay infectious for months, or even years?
Many people with Ebola symptoms actually have Malaria or typhoid, and they know it. There are already cases of survivors being shunned, probably because of the number of people they infect.
The prospect of being locked in with other patients, and survivors, when you are trying to convince yourself you just have a cold, is unlikely to be attractive IMO.
I made a comment a couple of months ago I think where I warned that instead of getting all worried about climate the US and other countries should get worried about Ebola. I said that if they didn’t pull their socks up and help stop the disease in West Africa, it would soon come to the USA. In other words if they don’t fight the disease over there, they will fight it over here.
Here is something to really worry about. Let’s say the USA banned every single African resident from visiting the US. Would that mean the US is safe from Ebola? I argue NO because it’s just temporary relief. Ebola can make its way to India, China and what about southern Europe with its daily influx of illegal migrants. As long as other countries don’t carry out a ban on flights from Africa the threat will just take a little longer to enter the USA. Just my thoughts.
The WHO says “Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.”
The CDC says “Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus has been found in semen for up to 3 months.”
CLARIFICATION. Added sentence in bold.
“I argue NO because it’s just temporary relief. Ebola can make its way to India, China and what about southern Europe with its daily influx of illegal migrants. Infected Indians, Chinese, Italians etc can then make their way to the USA.“
“Ebola can make its way to India, China and what about southern Europe with its daily influx of illegal migrants. ”
Don’t worry about Europe. Because it can take months to travel on land through Africa to the Mediterranean. Says our media. Nothing can therefore happen.
Once an engineer at an ammo factory explained to me that they tested the tightness of their ammunition in negative pressure of 9 atmospheres. I wondered how, but unfortunately he couldn’t demonstrate it to me because it was a military secret. It still remains so, as far as I know.
No, they didn’t.
There’s no such thing as negative pressure… only pressure less than what you think of as being neutral.
The only way to get -9 bar of pressure is to have the high side of the gauge at a pressure at least eight bars above atmospheric (roughly speaking).
Physically, it’s the equivalent of saying that something has negative mass.
Sure you can have negative air pressure, but it requires the low pressure side have a temperature well below absolute zero. 🙂
Most thankful for your clarification. Honestly I had some doubts about his claim.
LeeHarvey October 22, 2014 at 11:49 am
I think there are two possibilities here. The pressure of any gas is directly related to the density of the gas. If you have a non-compressible container from which you evacuate air, the pressure inside the container will be less than 1-bar. Is this not how a vacuum chamber operates? I don’t see how this is the equivalent of ‘negative mass’.
Philip T. Downman’s munitions engineer could have referred to testing sample munitions in a vacuum chamber. They would evacuate air down to some predetermined PSI and if the sample munition did not leak it passed. This assumes the projectile was loaded into the casing at 1-bar (14.5 PSI).
The second possibility is they used a pressure chamber. Since a complete vacuum is 0 PSI I don’t see how you could get to negative 9-bar in a vacuum chamber. You could theoretically get a negative 9-bar pressure change by first pumping up a pressure chamber to positive 10-bar and decompress to 1-bar suddenly, say by breaking a seal. If the projectile had been loaded into the casing at 1-bar, though, I don’t see how this would be a very useful test. However, if the projectile was loaded while in the pressure chamber at 10-bar and then suddenly decompressed, I could see that as potentially useful for testing the projectile/casing seal.
Michael –
You’re confusing gauge pressure and absolute pressure. Sure, you can have an absolute pressure down to, for all practical purposes, zero. That doesn’t mean that you’re at negative absolute pressure.
Think of it this way – a standard atmosphere is about 100 kPa (101.3 is actually the number that’s permanently burned into the brain of anyone who’s ever taken thermodynamics). If you evacuate a chamber as much as is practically possible, you’ll get down to within spitting distance of 0 kPa absolute, but you’ll still only be 100 kPa below atmospheric pressure, or at -100 kPa gauge pressure. Saying that a chamber has a pressure nine atmospheres below 100 kPa is saying that it’s at -800 kPa absolute, which is basically the same as saying that you can have a mass that’s 9 kg less than 1 kg.
If I had to guess what gave rise to this misconception, I’d have to say that it’s the habit people seem to have of saying things like ‘nine times less’ when they mean 10%. I could see ammunition being seal tested at 10 kPa, which people who are really bad at math (and English) might call ‘nine times less’ than atmospheric pressure, but isn’t remotely the same thing as being nine atmospheres of vaccuum compared to atmospheric pressure.
Technically, atmospheric pressure can never be negative. This is more properly referred to as gauge pressure.
The solution to the Ebola problem is very simple: Lysol! Wash everything all the time. We should send several shipping containers of Lysol to Liberia, Guinea and Sierra Leone.
Inviting people with a deadly disease to visit, could only happen under this President…
Atmospheric pressure can’t be negative but pressure in a room (or car with a/c running) can be less than ambient air pressure outside, so in that sense relatively negative.
http://en.wikipedia.org/wiki/Negative_room_pressure
As for ammo testing, ICTYBTIWHTKY. Just kidding.
The paranoia and ignorance shown by this article is extraordinary, reveals a basic misunderstanding of the disease. The number of people from three of the poorest countries on earth being able to afford to fly seems to be grossly overestimated also. Here we have one of the richest nations on earth complaining about the potential cost of helping people from three of the poorest. The flights are necessary to allow the transport of health workers and protective clothing, not to mention other medical equipment, into the zone where these are desperately needed. Workers are being rotated on a monthly basis and need a three week ‘cooling off’ period. Stopping flights just makes their mobilisation ten times harder. All Americans seem to worry about is some imagined bogey-man coming from Africa to kill them all. Grow up!
Take your own advice!! And drink less Kool-Aid.
A chartered Boeing jet will haul a lot of aid to the affected region. When the care givers work is done and they are shown to be incapable of spreading the pathogen back home they can come home the same way. I suggest we offer up Air Force 2 and give Michelle Obama a bus pass for her campaign activities.
Michelle Obama does not use Air Force 2.
..
Air Force 2 is used to fly the Vice President.
Juan,
That may be the theory. But when Valerie Jarrett gets to take Air Force 2, then we know the score: whatever the President says, goes.
If V.P. Joe Biden doesn’t like it, what’s he gonna do about it?
RE: Air Force 2 designation – it is a technicality that is not important to the facts.
https://www.judicialwatch.org/press-room/press-releases/obamas-ireland-trip/
The larger point is this country can afford to fly critical people anywhere in the world at a moment’s notice and still have money in the bank to air drop a load of new weaponry into an ISIS compound.
Mark,
Don’t see anyone wanting to avoid helping. Do see a lot of folks looking at how to help A LOT with minimal back contamination. You seem to suffer from the same Hubris that has already infected 2 nurses in Dallas, cost $1/2 Million (that would have done a lot better as aid shipped to Africa) and potentially started a second USA hot spot in Ohio.
Please realize that you DO NOT KNOW THIS DISEASE. An exposed person is NOT safe after 21 days (just 95% of them). A person is NOT free of infective risk prior to a fever ( 12.9% are infective without fever). This disease CAN and DOES spread to animals who give it back to people (and you can not contact trace animals).
It is the sheer stupidity of that hubris that will kill a large number of people. If this is not contained, and pronto, it could be up to 1/2 of the world population. Yes, it is that serious. That you (and others in charge) don’t realize that, is a blinding strobe on that lack of humility.
It is NOT in any way a bad thing to ship a couple of our nice military CBW (emphasis on the B) hospitals over there and use a load of military and charter planes to haul in $Millons of aid and medical staff. Preventing travel OUT does not prevent supplies and personnel IN.
Oh, and per “rotation”: Since medical staff are at significant risk of getting the disease, they ought to ‘rest in place’ in a quaranteen compound in Africa. Not be hauled all over the world to find out after they have wandered off to weddings and cruises that they might ‘have a problem’. (If you don’t see why that is an ‘issue’, see the existence proof of Dallas…)
E.M.Smith
Can’t see how, if it’s not transmitted thru the air and only thru “bodily fluids”. Correct if wrong.
Who is advocating stopping flights to the Hot Zone? Stopping travel from it is another matter.
Exactly. Heard a conversation on the BBC around a UK school refusing to allow a child from an infected country come to the school while his mother was diong some charity related work in the UK. The Beeb ( and many others in the UK ) were appaled at this. Jeremy Vine asked the mother some questions, and soon had established they lived within the quarantined area. You could hear his attitude change as he got more answers to his questions. He then established the airport was within the quanrintine area, yet flights were still leaving!
“All Americans seem to worry about is some imagined bogey-man coming from Africa to kill them all.”
Just watch that exponential double a few more times… (It doubles once a month)
The best reply to the current idiocy I’ve come up with is that if the 150 Africans a day coming from the hot zone all decided to cancel their planned trip to Disneyland because Disney’s latest movie bombed, the effect on transmission would be exactly the same as a travel ban.- no people from the hot zone traveling to the US. But following the CDC’s logic, this also means that the international efforts to contain one of the world’s deadliest diseases would be severely hampered, perhaps even collapse, because Disney’s latest movie bombed and Africans canceled their vacations in disgust. That’s simply absurd – as is their thinking.
obama says any restrictions on travel will just make it worse….
…and that’s why we are putting more restrictions on travel
Doing it the Firestone way-
“FIRESTONE, Liberia—As Ebola exploded here this year, a rubber farm embarked on a crash course on how to tame an epidemic that has killed thousands of people and derailed governments across West Africa.
One morning in March, when the first case arrived at the Liberian unit of Japan’s Bridgestone Corp. 5108.TO -2.96%, managers sat around a rubber-tree table and googled “Ebola,” said Ed Garcia, president of Firestone Natural Rubber Company LLC. Then they built two Ebola isolation clinics, using shipping containers and plastic wrap. They trained their janitors how to bury Ebola corpses. Their agricultural surveyors mapped the virus as it spread house to house, and teachers at the company’s schools went door-to-door to explain the disease.
“It was like flying an airplane and reading the manual at the same time,” said Philippines-born Mr. Garcia, who runs this 185-square-mile stretch of rubber trees.
Six months later, Firestone has turned the tide of infections, offering a sanctuary of health in a country where cases are doubling every three weeks”
And they lost how many..?
54 out of 71 cases. Normal mortality.
Seems to me Nigeria got it right, or so far anyway, and good for them.
Maybe Mr. Obama should listen to his distant relations.
African countries neighboring the three affected states have managed to close their borders effectively against the disease, too. Non-African nations should take similar precautions, IMO.
Taking a short break from the terrorist shooting in Ottawa…
I was an “atomic radiation worker” in my capacity as a nuclear engineer at a nuclear power generation station. The “hot” areas in the nuke plant, and the protections in place, are very similar to those in the biological environment. I am now a medical systems engineer.
I am qualified to speak expertly on air flow in sterile environments like surgical centers and operating theaters,
Despite the subject matter being off topic wrt global warming and climate/environmental it is an extremely important issue and has the capacity to dwarf global warming in very short order. Besides, WUWT’s previous banner referred to other interesting scientific subjects so this article falls into that category.
Ebola is not “airborne” but is does move through the air within moist particulate (aerosolized liquids) and will survive on dry particulate for a limited time. I obtained that information from the CDC publications.
The exhaust air from negative pressure rooms must be properly treated to remove the dangerous contaminant whether it is a particulate, a radionuclide, a chemical or a biological agent. Where does the exhaust air go? How does one deal with the filtration? Who deals with filter changes? How is the air treated?
In treating the ebola virus, significant use of complex infrastructure will be required. There is not a lot of it in the USA. There is only 11 beds (CDC quote) in the USA capable of properly dealing with an infected, living, patient. A large outbreak has the potential to overwhelm current installations rather quickly so it is reasonable to OVERREACT to keep the number of treated patients in the single digits.
Each infected patient requires the involvement of dozens of health care workers and 100’s of support people. Human resources has the the potential to be rapidly overwhelmed with a large outbreak.
It is exceedingly appropriate that A Watts carry a column on this issue as it develops. Really, who else is credible? the CDC? NIH?
I suggest that Anthony seriously consider an aggregation of the ebola data, models, infected & death tracking. I suggest that WUWT become a reliable resource for this dominating science/medical/social/political issue.
100 thumbs up both to the original article and your and other comments here. Jo Nova in Oz is already doing something like what you recommend for Anthony. Jo’s blog was where I first encountered the Firestone rubber story. Frightingly the US military lab has recently said that Ebola is not very airborne
contagious in the moist warm air of Africa, but is in the cooler dryer air in the US. I am not panicking, but since I reside very close to the airport where the first Ebola patients arrived and have been to the Emory medical complex many times I am worried.
The general consensus here appears to be to stop the flights. I agree completely. Since Obama doesn’t want to do that sensible thing, and since he’s always wrong, only reinforces my opinion.
Stan,
I have a suggestion to make as to why the administration has and will not take any action regarding reducing human migration by way of flights or any other mode of transport.
1) The purpose of the CDC is NOT to protect individuals. It is to protect the human herd and civilization. Humanity can suffer a 70% loss and still survive reasonably well. They would rather allow a few people to circumvent the expected transportation methods to allow them to expose the weakness in the system. In essence, the few people who will carry ebola to the USA are an essential component to the CDC’s model verification. Individuals are expendable in service to the greater interests of science. I don’t advocate this but it does make for good science if one is completely amoral.
2) They can’t call a stop to transportation and then also enforce it. The government does not have the manpower or infrastructure to stop a rush through the borders. If the administration declared the borders closed (HAR HAR) who would listen? To make such a declaration would a) not work, b) create a rush to get to the USA, and c) expose the impotence of the government to do anything about it. Better for the administration to look stupid than reveal the reality of its impotence.
3) The administration will NEVER admit that any bad can come from a region inhabited by mostly black people. Sadly, the election of Obama, imagined by many to create a post racial nation, has created a radical racist America where skin color is a variable in every calculus. That is the OPPOSITE of Martin Luther King’s dream and it was perpetrated by a black man, ever-so-willing to silence decent by having his minions cry racism at every turn. The accusation of racism is the last refuge of a racist.
4) Reason never prevails. We are living is a world of PC, propaganda and BS!
Well, the immune survivors strategy sounds appealing, but it does not address the risk of the virus mutating. Other VHFs have been controlled using basic barrier precautions, using non-immune personnel. Bleach. LOTS of bleach.
Using basic quarantine rules developed over the centuries is what stopped SARS, and this is genuine settled science. Control access to the hot zone, and use full body coveralls with face shields. Disinfect everything with something that is overkill against Ebola.
Ebola or another VHF like Marburg has been suggested as the pathogen causing the 430 BC, et seq, Plague of Athens:
Olson, et al. (1996), “The Thucydides Syndrome: Ebola Déjà Vu? (or Ebola Reemergent?)”, CDC Letter
http://wwwnc.cdc.gov/eid/article/2/2/96-0220_article
The authors translate Thucydides’ phrase “λύγξ κενή” (“empty heaving”) as “hiccups”, a symptom of Ebola. It had previously been read as “dry heaves” or the equivalent.
milodonharlani , here is some more. I was just going to post it but thought to see if anyone else mentioned it first. These guys present 6 pieces of evidence that basically says it wasn’t the rats or the Plague and compares Ebola’s incubation and symptoms to the ‘plague’ of the time.
Let’s not forget Ebola’s close cousin the Marburg virus disease (MVD) (formerly known as Marburg haemorrhagic fever) – 1967. This disease came from imported monkeys from Uganda and caused epidemics in Belgrade, Frankfurt and Marburg.
http://www.who.int/csr/disease/marburg/en/
While the apparent resistance to HIV found among some in Northern European populations suggests a possible viral agent behind the Black Death, recent DNA studies IMO pretty conclusively show that the plague pathogen was indeed the bacterium Y. pestis:
http://www.livescience.com/15937-black-death-plague-debate.html
However it may have been a different strain from the more slowly moving modern variant, possibly transmissible by lice or from human to human, thus bypassing the rat & flea route. Plus whichever strain was responsible, it was most likely more virulent in a naive population than now, as with for instance syphilis.
I believe there were three forms of the black death: two were rat / flea born (starting in the arm pit or groin) – this was the bubonic plague and the other air born – this was the pneumonic plague. The first two entered through the skin while the second entered through the lungs and was transmitted through coughing and sneezing. I understand this is where the tradition of saying “bless you” when people sneeze originates (because the “sneezer” may have just killed everyone in the room).
There are many accounts of both forms in the journals of the time (which is how I became aware of the third form). Although the flea vectored form was not identified as flea vectored – the symptoms were slightly different from the air born form primarily because the pneumonic from had a 90% mortality rate and killed so quickly that the swollen lymph nodes did not usually have time to appear (a well known feature of the more widely discussed bubonic / rat-flea vectored form). The air born form might appear in a country village after an infected person arrived where it would wipe out a small village in a matter of days. It appears to have allowed direct transmission from person to person, thus achieving the same speed of transmission as an Ebola/Marburg form and is a more likely explanation than a VHF virus I suspect. I recall reading long ago some discussion that the bacterium might be able to mutate from one form to another allowing it to exploit both vectors of transmission.
Interestingly, at the same time as the plague was sweeping Europe, many cities blamed dogs and cats resulting in laws requiring the extermination of the same (particularly cats) – a response that exacerbated the rat infestation. Further rats were often kept as pets and eaten as a meat source. This, combined with the fires that followed the plagues in a number of metropolitan areas might partly explain why there are not the piles of dead rat carcasses.
At some point more Americans will be banned from entering other countries, out of caution. At least it’s not a “lifestyle” pandemic yet.
Get your ACA signup forms while waiting at the airport isolation areas. It will take months or years for anyone to say you are not a citizen. The same system that decides who is a citizen also gets credit for ACA expansion rate in the mean time.
Hey, this is all moot since Ebola is not airborne…
/s
If I have Ebola, my fluids, eg. sweat, saliva, etc. carry the virus, which can survive on surfaces for hours at least.
Ebola has not been found to be transmitted via sweat.
CO2 has not been found to cause global warming.
The Ebola virus has been detected in sweat, so it could indeed be transmitted therefrom:
http://www.cdc.gov/vhf/ebola/transmission/qas.html
Not moot at all. If an infected person coughs or sneezes, ebola is ‘airborne’.
Ebola is NOT ‘airborne’ in the strict medical sense.
Semantics aside, IMO it is valid to state that the Ebola virus is transmissible via bodily fluids, but doesn’t need broken skin to enter the blood stream of its next victim or host. Droplets can be transmitted directly to the eyes, nose or mouth of another mammal, or indirectly via some surface or substance which has been contaminated within the past few or several hours, depending upon conditions.
Jimbo October 22, 2014 at 5:32 pm
In the strict medical sense, I agree with you, which is why I put single quotes around the word ‘airborne’. So let me put it to you this way. You’re on a bus and someone across the aisle sneezes at you; would you feel reassured that ebola is not airborne in the strict medical sense? As mentioned in the article, all it takes is a single ebola virus to infect you. Is the distinction in the strict medical sense between ‘large-droplet’ and ‘small-droplet’ useful when all it takes is to inhale a single droplet, large or small, containing as little as a single ebola virus? Medical Science (TM) is not 100% sure exactly how and in how many ways this virus can get to you. They’ve changed their minds about a lot of things. How would you feel if next month or next year they suddenly announce: “You know what? We’ve decided that ebola can be airborne long enough to get you.”
Or would you agree with Eustace Cranch. Hey, it’s not a big deal!
Sheesh, even with the sarcasm tag, the sarcasm was not detected. Oh well.
There are some interesting possible treatments:
https://chiefio.wordpress.com/2014/10/03/potential-ebola-cure-hiv-anti-viral-drug/
references a CNN story on an African doctor who used anti-viral drugs intended for HIV and found one that gives a very high survival rate (if given early). http://www.cnn.com/2014/09/27/health/ebola-hiv-drug/
In comments, there are other things mentioned. Like the fact that Ebola has lots of coding for selenium in the genome and maybe it is sucking up all your selenium. Since selenium depletion has as a symptom hemorrhage, that would match. (Other symptoms match too…) So simple selenium replenishment might cut symptoms a lot.
There are others mentioned too.
https://chiefio.wordpress.com/2014/10/13/doubling-time-and-the-future/ looks at the amount of time at present doubling rates that we have. Many proposed ‘actions’ have delivery dates long after it is too late…. In comments a Chinese drug potential is mentioned: http://www.scmp.com/news/china/article/1616227/chinese-firm-pushes-ebola-drug-it-says-can-cure-deadly-virus?utm_source=edm&utm_medium=edm&utm_content=20141015&utm_campaign=scmp_today
https://chiefio.wordpress.com/2014/10/16/the-exponential-of-ebola-rolls-on/ compares growth curves (all upward sloping so far…) for various countries. Until they flatten, we are on the path to ‘toast’. Again, in comments, an interesting connection or two are made. In particular, that the 21 days is not a ‘bright line’ cutoff, but a 95% level. Some folks can go up to 30 or 40 days before becoming sick. Similarly for fevers. Some 12% of folks who get sick with Ebola do NOT develop a significant fever…
http://www.naturalnews.com/047267_Ebola_outbreak_incubation_period_viral_transmission.html#ixzz3GMSJ89zY
http://www.latimes.com/nation/la-na-1012-ebola-fever-20141012-story.html
The notion that 21 day quarantine and 100 F fever are known knowns will kill many folks…
Also, my personal worry, Ebola could become endemic to our animal population. Ever try to contact trace a million rats? One sick bum in an alley with rats and you lose New York City. Rats are used for lab animal models (though hamsters are better…):
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528289/
THE only way to prevent a global pandemic is to stop this disease from leaving Africa. You do that with shut down of travel, AND massive influx of medical care and money to the Hot Zone.
The sylvan reservoir & probable origin of the virus is in fruit bats.
Note that is stated as “believed to be bats” and it is not known what others might also exist. It is also unclear what species barriers do or do not exist, for further hosts. It is known that the virus infects many species, from dogs and pigs to rodents and primates. Even some antelope (via test injection, not found in the wild). So saying anything about what animals this will or won’t move into on a whole new continent is pure speculation.
The basis of that belief is that Ebola is most closely related to fruit bat viruses. It appears to infect & cause sickness in a wide range of mammal species. The dog of one of the infected nurses has been found free of the virus.
Fruit bats are widely eaten in West Africa:
http://www.theguardian.com/society/2014/aug/23/ebola-outbreak-blamed-on-fruit-bats-africa
Did you mean rural West Africa? [Guardian: “Fruit bats, however, are widely eaten in rural west Africa”].
There are many Muslims in West Africa who consider bats as Haraam food (not to be eaten), though maybe some do.
Also, my personal worry, Ebola could become endemic to our animal population
scares the hell out of me……if this gets into central america which is no different than west africa
Hardly surprising that the HIV drug worked on Ebola since it’s a reverse transcriptase inhibitor and both are retroviruses which use reverse transcriptase to replicate.
Also rats don’t get Ebola.
I would add two more things. First I would put an ultraviolet light on the inside of the duct that draws air from the room. Second, I would add ozone in the same duct. Either and both should be enough to kill any pathogens in the air and to make sure they do not make it out of the room alive.
In fact, I think hospitals should have both of these items on their air handling systems as general practice, to ensure that other diseases are less likely to spread.
Yes indeed. Both ultraviolet and H2O2 water treatment is superior as well. But as others state, the disease needs to be isolated in country of origin. We now have another example of the moron et al in D.C. too busy with golf handicaps. The obvious purposeful intent to bring Ebola virus onto the North American continent is irresponsible, inept, and criminal. How many more travesties need to occur to wake up the sleeping?
For those not worried about Ebola. Imagine if you were on a plane and someone around you spent the whole flight sneeze and hacking. Now you are probably irritated that this person is so inconsiderate as to spread their cold or flu. After the flight you find out the person had Ebola. Would you be concerned for your own health ? Experts are saying it can be on the droplets being expelled by the cough, and can be contagious for up to 3 hours on a hard surface.
Sneezing is not a symptom of Ebola so not very likely.
Yet people with Ebola have been known to cough and sneeze. From the CDC link just cited:
“Unlike respiratory illnesses like measles or chickenpox, which can be transmitted by virus particles that remain suspended in the air after an infected person coughs or sneezes, Ebola is transmitted by direct contact with body fluids of a person who has symptoms of Ebola disease. Although coughing and sneezing are not common symptoms of Ebola, if a symptomatic patient with Ebola coughs or sneezes on someone, and saliva or mucus come into contact with that person’s eyes, nose or mouth, these fluids may transmit the disease.”
CDC “social justice” activism:
http://www.city-journal.org/2014/eon1021hm.html
“Heather Mac Donald
“Infected by Politics
“The public-health profession is more committed to social justice than to sound science.”
One of the solutions is to provide reliance when fighting this disease – or any disease – by sharing resources.
A National Health Service would help the USA.
He he he
You’re kidding, right? No NHS necessary, just a regime willing to take needed measures rather than engage in PC blather & encourage immigration from the stricken continent.
What might help would be if we had a regular instead of acting Surgeon General, a replacement for whom Democrats in Congress have resisted, so that Obama wouldn’t have appointed a political hack as Ebola Czar.
If the CDC weren’t a hotbed of “social justice” activism instead of public health action, handling of cases in the US wouldn’t have been so bungled.
But I do congratulate the UK on its screening of passengers, & am glad your one known case so far recovered, although a British citizen did apparently die of the disease in Eastern Europe, IIRC.
The president’s nominee for Surgeon General has been blocked by the Republicans out of deference to the NRA, Rand Paul has put a hold on the nomination, so you should put the blame where it is due.
As you must know, there are 55 Democrat Senators, & Reid has changed the rules to disallow filibusters for nominations. Hence, there is nothing stopping the majority party from confirming the administration’s nominee if it wanted him.
The reason he hasn’t been confirmed is that several Democrats running for reelection in states where gun control is unpopular dare not vote for him, after his anti-gun activism. Reid himself, wanting to maintain control of the Senate, also doesn’t want to provide GOP candidates with another issue.
So I did put the blame where it is due.
Things to consider:
1. Small containers that require hermeticity are put in a pressure chamber with several atmospheres of Helium for a specified time. The chamber is then evacuated to a high vacuum and checked with a mass spectrometer that is tuned to Helium.
2.The Ebola virus is about 90 nanometres in diametre and 750 to 1200 in length. the pore size of the hazmat suits being used is 450 nanometres. Consider an isotonic solution containing Ebola on the outside of the suit and a hypertonic solution on the inside of the suit (dehydrated sweat, etc) at the same location. Would Ebola be carried through?
3. The only suit that can be safely used wit Ebola would be a CBRE suit with the proper support equipment and protocols. ( Washdown before assisted outer suit removal, in a negative pressure room. etc,etc)
4. Reality Check. Hospitals should be scored and audited for infectious disease control on a regular and ongoing basis. MRSA has killed and will most likely kill more people than Ebola.
5. I would not expect the UN to be very effective. They have done very poorly with the Cholera in Haiti.
A very good article. It seems overwhelmingly obvious that travel to or from West Africa should be banned with the exception of support workers who can be monitored on return. If we fail to provide a route out for western health workers the flow of volunteers will simply dry up.
The alternative is to risk an outbreak in Europe or the US. Both countries are capable of effectively monitoring, tracking and treating a limited outbreak, but the risk of a more widespread infection is both real and ruinously costly both in treatment and economic fallout.
The black death in the 14th century killed approximately 30% of the population. It was over 100 years before populations returned to pre-infection levels and totally changed the economic and social landscape.
Whist we now have a far better idea of drugs and disease control, it is a sobering lesson of what may happen if an epidemic overwhelms medical facilities and normal services (food, power, law and order etc) become seriously compromised.
I hope the survivors are being used to supply blood plasma, which is apparently effective in treating the disease.
There’s not much evidence to support its effectiveness yet and even if it is what are the important variables, such as when the blood should be drawn and when administered. By the time a patient is symptomatic the viral load in an Ebola sufferer is huge, much greater than in HIV and most other viral diseases, so the antibodies in the transfusion have an uphill battle to deal with the virus. Obviously the earlier the better but the longer it is since the survivor recovered the lower the level of antibody in the plasma.
One thing in the original article that hasn’t been addressed in the comments is the utter folly of sending US military personnel to West Africa. Of course since Obama ideologically hates the military, he doesn’t care if these poor men live or die.
True words.
As the gentleman father who lost his son Aaron Carson Vaughn, a member of SEAL Team VI who was killed in action in Afghanistan said:
“As Commander-in-Chief, your actions — or lack thereof — Mr. President, cost lives. As you bumble about in your golf cart, slapping on a happy face and fist-pounding your buddies, your cowardly lack of leadership has left a gaping hole — not only in America’s security — but the security of the entire globe. Your message has come across loud and clear, sir: You are not up to this job. You know it. We know it. The world knows it.”
Hopefully, our lifestyle of better personal hygiene will improver further and the virus is contained. Otherwise, I hope you all like the idea of the USA becoming a third world disaster area.
Alec, thank you for the effort you have put into this timely article. The ancient Greek solution is a very practical idea given the difficulties in the hot zones.
There is an additional simple measure that is reported as effective. Boring old rehydration with salted water or Gatoraid. This improves chances of survival of victims and reduces infection risk to carers by reducing vomiting and diarrhea.
R(sub)0 is actually pronounced using the British style, R-naught.