It's not quite time to go into full Dustin-Hoffman-killer-virus-movie paranoia yet, but the it seems the inability to safely process the biohazards, bodies and healthcare paraphernalia is a real problem. Even if you're quarantined, someone eventually has to cleanup the mess you leave behind and its becoming tricker to do.
Ebola is a incurable and statistically fatal disease, but it is being made worse by people wanting to see their families and friends before their will likely expire. This behavior places infected persons in communities and situations where proper care and quarantine may not be available therefore the disease has spread. People acting in their own self interest when confronting their mortality is nothing new. We'd likely all do the same.
Maybe we need to start treating this outbreak we fight wildfires. Start digging a proverbial fire line. Setting broad travel restrictions and geographical quarantines and hope that the virus fades away over time. Of course this is cruel and inhumane to people with the disease not to mention impractical to implement physically over such a wide area because people inside any area would rush out possibly taking the virus with them.
Do you know of any countries where 'proper' borders exist, other than those between East and West Germany, and North and South Korea, which existed for political reasons and economic reasons?
Or the one between the USA and Mexico, which has more to do with a dislike of the racial makeup of those wanting to cross into the USA?
Isn't a border nothing more than a line drawn in the sand patrolled by armed men in places where it is feasible?
If animals can cross borders at will, then why can't humans also? After all humans are a peculiar breed of apes without fur?
Only cover these two segment of the border. Spain is part of the Schengen area, as well as Portugal and France, so there is no need to have a real border with them.
That would be South Africa - Lesotho. Frankly Lesotho barely qualifies as a country though...its 100% surrounded by SA, 100% dependent on SA and its currency is linked 1:1 to SA.
It was more of an example though...borders pretty much don't exist in Africa. The only people that get formally checked are those using the roads & border posts. Once you're on foot its a free for all. Hell there are people repeatedly using deportation mechanisms as a free ride home after doing migrant work.
As for the issue at hand...I have little faith in Ebola being contained to be honest. The overall social setup is uniquely incompatible with containment. That being said Rwanda etc have demonstrated a reasonably approach to AIDS (awareness driven) which did impress me.
This is what China did during the SARS outbreak. Not only were people not allowed to move around in the country, but entire hospitals were quarantined so that people who got SARS would be sent there to die. My father was stuck in China during the entire SARS crisis in a small village and he was forbidden to leave. I called him several times during this period so it was eyeopening.
Yes, the other affected countries also took proactive quarantine measures. And that's the reason why a hundred million people are alive instead of dead today. Seriously: SARS was deadlier than the 1918 flu, which killed several tens of millions. That's the fate that was avoided. Quarantine works.
I believe he means each individual viral infection has a higher probability of resulting in death. The epidemic as a whole was less deadly, but he's arguing that's only because of the quarantine restrictions put in place.
There have been cases in Liberia of people in a neighborhood physically stopping people attempting to disinfect an ebola infested room. Do you just call for martial law in a country that still have civil war on the mind? Do you call for it when there are only ~200 cases in a country of 4 million and risk an outbreak of one of the more horrific civil wars?
The problems we are seeing don't have any clean solution because the actual solution is quite simple, but it failing to be employed properly.
The first problem you identify leads into the second. This is Africa. The same reason you can't quarantine and dispose of medical waste is the same reason you can't set travel restrictions and the like.
I think one key this time could be that mortality is down from 90% to 60%. If the virus is less aggressive, infected people have more time to move around and spread it.
The lead doctor in Sierra Leone in charge of fighting ebola himself got Ebola. If it's not that easy to contract ebola, you would have thought the foremost expert would have easily been able to avoid this.
Actually, you might expect him to be a lot more likely to catch Ebola. He's coming into deliberate vicinity of the virus on what one assumes is a weekly or even daily basis. Frequency effect is in play.
For similar reasons, you'd expect the world's foremost expert on avoiding shark attacks to be attacked by a shark more often than the general population. He's out there practicing his theories and doing his research every day. The rest of us aren't going in the water as often.
The best way to avoid being attacked by a shark in the ocean is not to go in the ocean. The best way to avoid contracting Ebola is to stay as far away from Ebola as possible. An expert might be better able to handle himself around Ebola, or around sharks, than the rest of us. But he's also more likely to be around Ebola (or sharks) in the first place.
Doctors are always at risk of exposure. If you deal with patients with virulent diseases all day long then that's equivalent to playing the lottery every day all your life.
All it takes is a single mistake, or one vector of transmission that was not yet known, or one patient sneezing at exactly the wrong moment or simply not having the tools and supplies to do the work safely.
Being a doctor in this field is a very high risk occupation, doing it in Africa is simply very brave.
Tekmira Pharmaceuticals has a cure for Ebola that has success in non-human Primates. Is it unethical to try using this on infected humans that are going to die soon?
It's not like we need a special control group if that control group is supposed to receive no treatment - we know rather well how untreated Ebola works and the mortality rate.
If we try out drug X and only 50% of those people die, then we know that drug X is good for Ebola. Once there is drug Y to try, then we can use drug X for a control group.
You must be sure that you are measuring the same mix of virus strains, that the patients are receiving the same medical care and food, that the hygienic conditions are the same (the patient was going to survive, but a diarrhea just killed him), room conditions (is the room temperature important?).
You must be sure that you are using the same criteria to count the patients. Are you going to count the almost dead patients as a drug failure, or drop it from the list? Are you going to give the drug to suspected cases or only to confirmed cases? Do you count small children (they usually have a smaller survival rate)?
Are you counting the people that die before going to the hospital? Are you counting the (few) people that survive without going to the hospital?
If you get a 30% cure rate, (and suppose that the standard cure rate is 20%), it's very difficult to be sure that the improvement is in the mew drug and not in a change in all the other factors or some unwanted statistical trick.
Most of the rules for double blind studies are there because in the past there have been many "successful" test of new drugs, that were later retracted. It's very easy to measure incorrectly, especially when you really want the experiment to be a success.
(Another rules are there to prevent the consequences of previous "unsuccessful" test, were the "cure" was much worse than the illness.)
With their approval, naturally. Why not explain what we have, that there unknown risks, etc, but it could save you. The alternative is a painful, awful death anyhow so why not?
I feel like a control group is immoral at this point.
I think it would be pretty easy to get approval, everyone knows what happens without a possible cure. The control group would be everyone to date who hasn't received anything (or who refuses care).
Update to the story: "Meanwhile, in Nigeria, the health minister Onyebuchi Chukwu said that all other passengers on board the flight with the infected man had been traced and were being monitored."
Freetown, the Sierre Leone Capital, has had it's first case and seems to be having problems controlling the movement of infected people, one (now unfortunately dead) was 'rescued' from quarantine by relatives. "The woman had been one of dozens of people who tested positive but were unaccounted for, the BBC's Umaru Fofana reports from the capital, Freetown."
The United States and ALL of our allies need to restrict travel from every country where at least ONE case of Ebola has surfaced. We also need to restrict travel to and from ANY country that is not doing the same. We need to start practicing isolation/quarantine of certain sovereign nations immediately. I don't think Obama will do it. He's going to get us all killed.
> The United States and ALL of our allies need to restrict travel from every country where at least ONE case of Ebola has surfaced
When did this become an 'us versus them' issue, as though any people or governments are glad to have an Ebola outbreak on their hands.
Ebola is spread through physical contact with infect matter or fluids. It isn't airborne.
This looks like racism coming into play. Obama is black, Nigeria is also an African country. And what does it have to do with Obama?
Is he an expect on medical issues or is something for him to leave to the experts health issues are delegated to decide? And to think that you only signed on make this comment.
Don't let your fears let your behaviour degenerate into panic and racism.
Can anyone give me an idea on what would happen if Ebola ever did get airborne?
I know that its high mortality rate is a massive curb on its ability to spread, but is that enough to put a dampener on spread if it became more easily transmittable?
I don't think that is a thing that is really in the realm of possibility. We should probably be more concerend about a strain of the flu becoming deadlier.
Badly. We can't cut of international commerce, the world would starve. We can't cut of international travel, the world would starve and there would be a ton of riots.
If the outbreak is localized then we may have a change of putting a quarantine on the area, but I doubt it.
The good news is that there's a pretty good capacity to move massive amounts of goods with very little human interaction.
The bad news is that there's a hell of a lot of human movement, and you'd have to shut down much of that, as well as isolate carriers and exposed individuals as quickly as possible. Often in places (such as the present African outbreak) in which infrastructure, governance, and resources are exceptionally limited. The task of effectively controling all vectors would be a very high challenge.
I would assume that all first world countries have stored food/medicine/oil/etc. for emergencies. At least Finland keeps enough for six months consumption (was 12 previously, but with the current economic troubles it was dropped to 6 a few months ago). Of course that wouldn't include all the luxuries, but enough to keep people alive and the important industries running. And I suppose there would still be trade with countries that are known to be safe.
That would be an incorrect assumption in regards to the existence of medical stockpiles in all first world countries.
For example the closest thing to a medical stockpile in the United States would be the current inventory on hand and what the public or private sector has stockpiled for its own limited audience.
Perhaps there are exceptions for certain medications, but requiring 6-12 month stockpiles of certain medications tastes of corporatism.
It is a race between the incubation time (between 2 and 21 days) and the rate of transmission, including how long the virus can live in the air (huge difference between just a few seconds and a few hours) and where it is discovered. If it gets to a major airport we may be fucked.
Also such a huge mutation may lower the deadliness of the illness.
While the "meme" is quite crude, I have to admit that the whole Ebola situation constantly reminds me of Pandemic II and a clone I recently played on Android.
Ebola is a incurable and statistically fatal disease, but it is being made worse by people wanting to see their families and friends before their will likely expire. This behavior places infected persons in communities and situations where proper care and quarantine may not be available therefore the disease has spread. People acting in their own self interest when confronting their mortality is nothing new. We'd likely all do the same.
Maybe we need to start treating this outbreak we fight wildfires. Start digging a proverbial fire line. Setting broad travel restrictions and geographical quarantines and hope that the virus fades away over time. Of course this is cruel and inhumane to people with the disease not to mention impractical to implement physically over such a wide area because people inside any area would rush out possibly taking the virus with them.