maxomai | Entries tagged with ebola

Part of the reason why Ebola Virus scares the shit out of people is that caretakers are infected with the virus at an alarming rate. To prevent infection, caretakers use awkward, complicated, burdensome gear, and follow strict protocols for putting on and (very importantly) taking off their gear. Any failure in gear or protocol puts the caretaker at risk of infection, death, and passing the virus on to others.

An effective vaccine would of course make things enormously simpler, which is why the search for a vaccine has been a top priority for world health authorities. Fortunately, there are several candidate vaccines currently undergoing field trials. Unfortunately, one of the most promising vaccines just hit a snag. Some patients develop inflammation and joint pains after taking the vaccine, and we don't know why. The why is important. Joint pains are one of the long-term complications of Ebola, assuming one survives. If the inflammation is due to immune response, then could the faux virus have replicated? Is there a risk of infection?

Researchers are still working to figure out what's happening. In the meanwhile, we've hit the pause button on further research of this vaccine. And time is not on our side. As of this writing, there are over 18,000 cases of Ebola, with almost 7000 dead. And the virus is still spreading.

I see a lot of people on Twitter wondering how come Ebola just suddenly vanished.

If you're one of those folks, I have some good news, some bad news, and some ugly news.

The good news is, it disappeared in the United States, thanks to some very good health care. It's also disappeared from Nigeria, and, we think, from Mali, also thanks to some very good health care.

The bad news is, it's still raging through West Africa, and has killed over six thousand people. Sierra Leone just literally canceled Christmas in a desperate attempt to get the virus under control.

The ugly news is, we thought we had the virus somewhat controlled, but we don't. It's still spreading, and the general consensus is that most of the spread is happening where the medical community can't see it. Which means it may very well turn out to be almost a hundred thousand cases.

And there's still no cure, or vaccine. The only thing to do is isolate the infected, support their immune systems, and hope the patient is one of the 30% who doesn't die from the virus.

So, not only hasn't the disease gone away, but the threat to the rest of the world is still very real.

Happy Holidays!

Two months ago I posted the original "Ebola Post" to capture my thoughts on the West Africa EVD plague, with the intention of revisiting the topic once a month. Here's what happened since last time.

THE NUMBERS

On October 1st, WHO reported 7,157 cases with 3,330 dead. Today, WHO reported 13,567 cases with 4951 dead. The overwhelming majority of these cases are in the West African nations of Liberia and Sierra Leone. Cases are still doubling roughly every month. If the rate of increase doesn't change, we'll exceed 50,000 reported cases by December 31st, a million cases by next May, and a billion cases by Jan 1 2016.

THE GOOD NEWS

A month ago I predicted that we would exceed 15,000 cases by November 1st. Today's report indicates that we'll fall short of that mark. This is a big deal --- previous estimates had cases doubling every 21-25 days, and the new period appears to be longer than 30 days. The rate is still geometric, but there's indications that it's slowing (for now).

Senegal and Nigeria are officially EVD-free.

Several experimental vaccines are now in the pipeline.

Ebola flare-up in Texas appears to have been contained. While a couple of nurses in Dallas came down with Ebola, both of them recovered; no other cases have been reported.

The world is making plans to produce a million doses of vaccine a month by the end of 2015 --- assuming that an effective vaccine is found.

THE BAD NEWS

WHO believes that cases may be vastly under-reported, by about a factor of two or three.

Ebola has spread to Mali (to the tune of one case)

Ebola has also spread to Spain (to the tune of one case). Fortunately, all 83 of the contacts from that one case have passed the 21-day maximum incubation period without symptoms, so that outbreak is probably over.

Two weeks ago, a New York doctor who worked in West Africa and felt perfectly healthy, came down with a fever, went into isolation, and tested positive for Ebola, making him the fourth case in the United States. As of three days ago he's still in serious condition. It's also come out that he lied to the authorities about his travels, which means that they have to start contact tracing all over again. The implication is, there's a small but nonzero chance that someone outside the original contact trace might have EVD and not know it. This has led to states favoring mandatory quarantine, which has Constitutional issues.

The Dallas incident demonstrates that not all US hospitals are prepared to deal with Ebola. In particular, hospital staff were not trained on handling of Ebola patients, which led to two persons coming down with the virus, and hundreds of more exposed.

The resulting panic over Ebola is likely to lead to undue curtails of civil liberties (e.g. Maine Governor LePage trying to quarantine a nurse who poses no danger to the community). Of course, this is also going to affect November's elections somewhat.

ANALYSIS

The geometric rate of transmission is slowing, but it's still geometric. We still need more time to tell whether the measures we're taking will slow the rate further. Our best bet is still to find a vaccine.

PREDICTIONS

By November 30th, EVD cases will exceed 25,000 with 14,000 deaths. Almost all of these will be in West Africa. There might be a few more cases of EVD in the United States, but no flare-up, in part due to the containment measures being enacted in various states and Canada. The estimated cost to contain the epidemic will exceed $10 billion; world response will continue to be anemic at best.

A month ago I posted the original "Ebola Post" to capture my thoughts on the West Africa EVD plague. It's been a month since then, and the outbreak shows no signs of slowing. Here's where we are.

THE NUMBERS

On August 38th WHO recorded 3,069 cases of EVD. On September 29th the CDC reported 6574 cases with 3091 dead. The overwhelming majority of these cases are in the West African nations of Liberia and Sierra Leone. Cases double every 24.3 days or so, although the World Health Organization now puts the figure at doubling every 21 days. If the rate of increase doesn't change, we'll exceed 50,000 reported cases by December 31st, a million cases by next May, and a billion cases by Jan 1 2016.

THE GOOD NEWS

The nations of Nigeria and Senegal appear to have finally contained their EVD outbreaks.

At least one candidate Ebola vaccine has been proven safe to humans. Whether it actually works is another matter, yet unsettled.

One physician claims to have successfully treated 13 of 15 EVD patients with HIV retroviral drugs.

EVD is now on the world's radar in earnest. The United States has pledged close to a billion dollars in support; billionaires are pledging tens of millions.

THE BAD NEWS

CDC believes that cases may be vastly under-reported, by about a factor of ten.

Civil society is breaking down in Liberia, as food and medical care have become scarce.

A person in Dallas, Texas has been diagnosed with Ebola. This person flew to the US on September 19-20, came down with symptoms September 24th, went to the hospital, was sent home, returned to the hospital on September 26th, and was only then put under quarantine. It's almost certain others have been infected in the Dallas area. CDC is tracing contacts as I write this; hopefully they'll track them all down before the number of cases exceeds 25 or so. (Update 10/1: Dallas County HHS indicates that they've located and are monitoring 14 contacts, including health care workers. Ambulance crew tested negative, but one person is in quarantine.)

This is the second time that Ebola has struck in the United States --- the first was a harmless (to humans) strain that escaped a Virginia lab. This is also the second time that the West Africa Ebola plague has landed in another country via airplane.

ANALYSIS

The simple fact is that we haven't dedicated nearly enough resources to fighting the Ebola plague. It's still expanding at an exponential rate, and any hope that we can prevent the spread to other nations, or even other continents, have been disproved. The main question is whether we can continue to halt outbreaks in the rest of the world until EVD burns through every last person in West Africa, or until we can develop a working vaccine.

PREDICTIONS

By October 31st, EVD cases will exceed 15,000 with 7,500 deaths. Almost all of these will be in West Africa. The flare-up in the Dallas will have been completely contained. The estimated cost to contain the epidemic will exceed $10 billion; world response will continue to be anemic at best.

I've decided that I need to start documenting the spread of Ebola Virus Disease (EVD) in West Africa on a month-to-month basis. This is a story that is (or should be) on everyone's radar already. My concern is that even the news-aware aren't really tuned in to the grim reality of EVD, or how it could dramatically change our lives in the next couple of years. This initial post is a snapshot of my thoughts right now.
( Read more... )

What you can do

Right now, for your own survival, the best use of your dollar is to donate to an organization that's working to fight Ebola in West Africa. Most of all I recommend donating to Doctors Without Borders, who have been on the front lines of this crisis from day one. Here's a list of ten other organizations that can use your money now. Note that WHO is not among them; they take money from nation-states and NGOs, not from individual donors. That said, this is still a half billion dollar (or more -- perhaps much more) effort, and every bit that goes towards a participating organization helps.

Stay tuned, kids.

Finding God in a Dog

"I'll never listen to what Slade says."

Entries tagged with ebola

#Ebola vaccine trials halted.

In case you're wondering "What Happened to Ebola?"

The Ebola Update, Halloween/November Edition

The Ebola Post, October Edition

The Ebola Post

What you can do

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