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Charlz Guybon
Nov 16, 2010
Heartbreaking. So many people are out there running around infected that nobody knows about that I just don't see how this can possibly be brought under control.

http://edition.cnn.com/2014/08/25/health/ebola-contact-tracing/

quote:

Ebola contacts in Africa go missing
By Elizabeth Cohen, Senior Medical Correspondent
August 25, 2014 -- Updated 2151 GMT (0551 HKT)


(CNN) -- Earlier this summer, Kelsey Mirkovic, a disease detective with the Centers for Disease Control and Prevention, entered a hut with her team in Gueckedou, Guinea, to speak with a man who had Ebola.

Their mission: to get the names of everyone he'd had contact with while he was ill, so that they could stop those people from spreading the disease.

"Who lives with you here? Who has eaten off the same plate as you? Who has bathed you and taken care of you?" they asked him.

Just his wife, the man answered.

Mirkovic and her team knew that wasn't true.

They knew he had children, and they knew that in West Africa, families and even neighbors eat off the same plate and bathe and care for sick people. They explained to the man how important it was to stop Ebola, and that his friends and family would be treated with respect.

Their pleas didn't work.

Mirkovic saw this scene play out over and over again. One of her colleagues at the CDC who's worked in Liberia says preliminary data shows they could be missing 40 to 60% of the contacts of known Ebola patients.

"This is one of the hardest parts of the response," said Dr. Brett Petersen, a medical officer with the CDC.

Mirkovic agrees. She says she understands why Ebola patients don't want to name names: There was a rumor going around the communities she worked in that getting on a contact list meant you would die -- and the deaths would happen in the same order as they appeared on the list.

"I understand they're scared," she said. "But it's very frustrating."

The Ebola outbreak in the West African nations of Guinea, Sierra Leone, Liberia and Nigeria has killed nearly 1,500 people. Just one contact left un-traced could go on to start a whole new line of Ebola transmission.

"It's like fighting a forest fire. If you leave behind even one burning ember, one case undetected, it could reignite the epidemic," Dr. Thomas Frieden, the director of the CDC, told reporters at a press conference earlier this summer.

"Contact tracing is a formidable challenge," said Dr. Margaret Chan, director-general of the World Health Organization. "In some areas, chains of transmission have moved underground. They are invisible. They are not being reported."

There's no solid number of how many contacts have gone missing. Petersen said the CDC arrived at the 40 to 60% number because in some communities, each sick person has only listed an average of two contacts -- and households commonly have five or six people.


Mirkovic, an officer with the CDC's epidemic intelligence service, said when she and her team felt patients weren't being honest, they would try to get information from neighbors or community leaders.

Sometimes that helped, and sometimes it didn't.

"Unfortunately, there's nothing we can do," she said. "We can't force them" to give contacts.

The World Health Organization estimates that 10% of contacts will go on to develop symptoms of Ebola. Occasionally, some of these Ebola cases go missing as well.

"Many families hide infected loved ones in their homes," according to a WHO press release issued Friday.


Mirkovic, who left Guinea in the end of July, said she felt that the situation might improve as health care workers gain more trust in the community.

But there's another problem with that: the availability of workers to follow up with contacts.

For example, in Sierra Leone, there are 2,000 contacts that need following, but the group Doctors without Borders says they've only been able to follow up with about 200 of them.

The group's teams in Sierra Leone and Liberia are "stretched to the breaking point" as the epidemic is "spiraling out of control," the group wrote in a press release.

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My Imaginary GF
Jul 17, 2005

by R. Guyovich

Charlz Guybon posted:

Heartbreaking. So many people are out there running around infected that nobody knows about that I just don't see how this can possibly be brought under control.

http://edition.cnn.com/2014/08/25/health/ebola-contact-tracing/

It can't, following the current strategy. Institutional change results from crisis. I'm fairly hopeful on long-term improvements after short-term humanitarian disaster.

For example, I read a story about JFK Hospital's first week after reopening. The hospital now follows a policy of triaging care, where anyone not personally known by staff or from an endemic region is regarded as a potential Ebola patient. This is a positive improvement to JFK Hospital. This reduces healthcare worker fatality drastically. This puts enduring procedures in place which ensure adequate response to any future epidemic emergency.

This is also expensive and inefficient. This requires at least 12 individuals in full-body PPE per hour, per procedure. For instance, I read about a pregnant woman reporting to the hospital from an epidemic area, which immediately threw a red flag. She required a caesarian section to secure her child's viability. The patient was immediately isolated from the rest of the ward and secured in a private area with no accessible windows and a door which the patient did not have access to open. For what had been a routine procedure of three individuals requiring no special equipment a month ago, twelve sets of PPE were portioned out, cleaning supplies provisioned, and backup sets of tools and staff prep'd in case an hour passed. This newborn child survived; not all newborns will. From the standpoint of preventing infection, this was the best route to take. From the standpoint of delivering as many viable children as possible, those numbers will decline.

Long-term, this institutional change is necessary for the institution to survive this pandemic. These changes in procedure are also necessary for state development in Liberia. It is harsh to state it so bluntly: without the pressing motivation of immedate and assured death, cultural changes that allow for strong states and surpress patrimonialism do not occur. Death is assured, timing and quality of life are not.

Here are the dynamics at play in this epidemic:

1. Most African states are 'weak'; they have limited ability to implement policy without foreign assistance
2. Most African institutions are funded through tarriffs and donations; their stability is vulnerable to market forces
3. Africa is a net-importer of sustinance food energy by a wide margin; the white-owned latifundia were broken up in most nations, which has made their citizen's lives dependent upon American and Chinese domestic policy, often in obscure and non-conventional forms

Therefore, the continued outbreak of Ebola will produce the following impact:

A) Withdrawal of foreign firms; declines in exports=declines in tarriff receipt and increased cost for imports: expect rapid inflation, as inflation is a truly free-market driven tax

B) Rapid inflation and increased Western logistical insurance and re-insurance costs decreases the rate of imports, driving scarcity of medical equipment necessary to halt this pandemic and pricing food outside individual reach

C) Increased rate at which tropical infections are acquired, and rate at which both known and unknown tropical and other infections emerge from their natural hosts to human populations

D) Currently over-stretched resources are inadequate to cope with C; hence DRC's concurrent outbreak and the much increased liklihood of additional concurrent outbreaks and much decreased ability to implement best-practices of immediate response

So, what can be done to bring the pandemic under control while reducing liklihood for outbreak in non-pandemic nations and also increasing future corporate profit potential? Certainly, not the policies which WHO and healthcare institutions publicly advocate for at present. Their strategy has failed, and risks worsening the long-term stability of institutions in Sub-Saharan Africa: it's time for a new policy approach and a global, rather than continental, strategy. If they refuse to develop an adequate one for the worst-case scenario, the pressures of our global trade dynamics will.


E:
My advice? Enforce a ban on air travel to nations with an outbreak and all bordering nations. Force African elites to deal with the crisis at hand or die from denial. Do not allow those who can afford air travel to escape the epidemic and risk transmission to other developing regions in which similar dynamics as the ones numbered above exist. For nations which neighbor an outbreak nation, enforce quarantine on the border by either destroying any infrastructure which eases travel across natural barriers, such as bridges upon rivers, and patrol those natural barriers constantly and with international assistance, or construct adequate fortifications to create barriers and isolate potential infections for 42 days, rather than the popular 21-days of observation; the pandemic has reached the point where one must discard the interquartile incubation statistics and deal with those of 99.999% certainty. For enough individuals have been infected that only will 99.999% certainty prevent this regional crisis from becoming a global humanitarian disaster.

Tl;dr: treat this poo poo like a real-life zombie outbreak.

My Imaginary GF fucked around with this message at 02:23 on Aug 26, 2014

Safety Biscuits
Oct 21, 2010

Xandu posted:

Oh geez.

Good news about this, if nothing else; that seems not to be the case.

The BBC posted:

William Pooley, 29, returned to the UK on Sunday and is being kept in a special isolation unit at Hampstead's Royal Free Hospital.

[..]

The Shepherd's Hospice, where Mr Pooley provided palliative care for non-Ebola patients before moving to a hospital to work with people with the virus, said he was aware of the risks but determined to help.

"We consider him a hero," Gabriel Madiye, the charity's executive director, said.

ukle
Nov 28, 2005
Looks like the DRC outbreak possibly isn't contained and is potentially over a massive area -

https://translate.googleusercontent...SXve5rogZ5539Ww

quote:

Medical sources report a suspected case of hemorrhagic fever identified Monday, Aug. 25 in the town of Mbandaka in Equateur. This is a lady of 65 years living in the neighborhood Bongondjo which was conducted at the General Hospital Reference Wangata.

That is about 400km away from the previously known cases, although it is the biggest town near to the original cases.

Slaan
Mar 16, 2009



ASHERAH DEMANDS I FEAST, I VOTE FOR A FEAST OF FLESH
Well poo poo. If this is happening with a different relative of Ebola in another massive area with even more problems than West Africa has, Africa is hosed. Even worse: West Africa basically doesn't export anything minus a few crops like cotton and corn. But, Nigeria and the DRC both have massive natural resource exports. So these outbreaks in these nations do actually have the potential to spread disease to other African nations, from people traveling from their work sites back to their families in other nations.

I would not be surprised if South Africa and East African nations shut down all travel to them soon from these regions.

At least Benin is still safe. For now.

:smithicide:

Slaan fucked around with this message at 10:21 on Aug 26, 2014

School Nickname
Apr 23, 2010

*fffffff-fffaaaaaaarrrtt*
:ussr:
How likely is it that Ebola strain the migrating bat colonies can change in such a short space of time? Or is it that they're just picking up various strains as they move across Africa, so the West Africans caught one strain from one colony and the Congolese caught a different strain from another (maybe the same? :ohdear:) colony?

Volkerball
Oct 15, 2009

by FactsAreUseless
In Nigeria.

WoodrowSkillson
Feb 24, 2005

*Gestures at 60 years of Lions history*

Slaan posted:

Well poo poo. If this is happening with a different relative of Ebola in another massive area with even more problems than West Africa has, Africa is hosed. Even worse: West Africa basically doesn't export anything minus a few crops like cotton and corn. But, Nigeria and the DRC both have massive natural resource exports. So these outbreaks in these nations do actually have the potential to spread disease to other African nations, from people traveling from their work sites back to their families in other nations.

I would not be surprised if South Africa and East African nations shut down all travel to them soon from these regions.

At least Benin is still safe. For now.

:smithicide:

Just get the gently caress out.

Randandal
Feb 26, 2009

Volkerball posted:

In Nigeria.



I am surprised that the "immunizations" are free (or are they?) and that tempers my level of appalledness at this. Perhaps they're dispensing accurate knowledge about Ebola, which is the only true vaccination! :science:

e: "the disease of the egyptians" :wtc:

This doctor's email address is probably in my spam folder so at least I can send him a piece of my mind.

Randandal fucked around with this message at 14:58 on Aug 26, 2014

woke wedding drone
Jun 1, 2003

by exmarx
Fun Shoe
"The disease of the Egyptians?" Is that a reference to the Jews being passed over by the plague or something?

Why can't you solve guys like that with bullets?

WoodrowSkillson posted:

Just get the gently caress out.

Of Africa?

i say swears online
Mar 4, 2005

Randandal posted:

e: "the disease of the egyptians" :wtc:

It's a reference to the biblical plagues. I bet all the Joel Osteen-style megachurches in Abuja are going nuts.

My Imaginary GF
Jul 17, 2005

by R. Guyovich

Volkerball posted:

In Nigeria.



I'd give even odds on crazy doctor vs. Nigeria bought all of Japan and Canada's experimental vaccines.

WoodrowSkillson
Feb 24, 2005

*Gestures at 60 years of Lions history*

SedanChair posted:

"The disease of the Egyptians?" Is that a reference to the Jews being passed over by the plague or something?

Why can't you solve guys like that with bullets?


Of Africa?

He is an American working there, not a native of Benin, and considering Benin's proximity to Nigeria and the rest of the outbreak, I do not think getting the hell out is a bad course of action.

benito
Sep 28, 2004

And I don't blab
any drab gab--
I chatter hep patter

Aliquid posted:

It's a reference to the biblical plagues. I bet all the Joel Osteen-style megachurches in Abuja are going nuts.

There was a lengthy profile in Esquire or Rolling Stone or something weird--one of those serious journalism pieces to make the magazine seem important. Anyway, it was about a poor guy from Mexico who caught leprosy back in the 60s or 70s, but didn't know what it was. He worked his way up through the local folk healers, then faith healers, then some random clinic, and finally made his way to a better clinic in a slightly bigger village. The doctor recognized it and gave the following diagnosis: "You have a disease of the Bible." That phrase has always stuck with me.

Dude made his way to the US, lived in that Louisiana containment facility for a few years, and was at the time of the article living a normal life in Texas without any major damage from the disease. (Which I know is supposed to be called Hansen's Disease these days, but in casual conversation nobody knows what the hell you're talking about.)

Charlz Guybon
Nov 16, 2010
Is there a good reason the numbers haven't been updated since the 20th? I can only think of bad ones. :saddowns:

Sheng-Ji Yang
Mar 5, 2014


Charlz Guybon posted:

Is there a good reason the numbers haven't been updated since the 20th? I can only think of bad ones. :saddowns:

Well,

quote:

CDC Director Thomas Frieden, who is in Liberia to assess the Ebola outbreak, said today the contagion is “even worse than we’d feared.”

“This is an absolute emergency,” Frieden told WSB Radio in a phone interview this morning. “We have never seen anything on this scale with Ebola before. Unfortunately, this situation is going to get worse before it gets better. We’ve not yet turned the tide. The outbreak is ahead of our response.”

http://www.ajc.com/news/news/ebola-outbreak-out-of-control-frieden-says-in-libe/ng85M/

Lote
Aug 5, 2001

Place your bets
If dogs and pigs are asymptomatic carriers and society has broken down to where those animals are feeding on the dead in the streets, those countries are hosed.

Charlz Guybon
Nov 16, 2010

Lote posted:

If dogs and pigs are asymptomatic carriers and society has broken down to where those animals are feeding on the dead in the streets, those countries are hosed.

Surely we would have found out if they were before now, wouldn't we?

Sheng-Ji Yang
Mar 5, 2014


Charlz Guybon posted:

Surely we would have found out if they were before now, wouldn't we?

Ebola has been detected in chimpanzees, gorillas, fruit bats, monkeys, antelopes, porcupines, rodents, dogs, pigs and humans.

Charlz Guybon
Nov 16, 2010

Sheng-ji Yang posted:

Ebola has been detected in chimpanzees, gorillas, fruit bats, monkeys, antelopes, porcupines, rodents, dogs, pigs and humans.

Are they the same strains that can affect humans?

EDIT: Just found this hit ebola song!

http://www.theatlantic.com/international/archive/2014/08/how-to-make-a-hit-ebola-song/378980/

Charlz Guybon fucked around with this message at 08:17 on Aug 27, 2014

Randandal
Feb 26, 2009

Charlz Guybon posted:

Are they the same strains that can affect humans?

EDIT: Just found this hit ebola song!

http://www.theatlantic.com/international/archive/2014/08/how-to-make-a-hit-ebola-song/378980/

That song's amazing.

Knowledge is the best vaccine! :science:

treasured8elief
Jul 25, 2011

Salad Prong
I heard over the radio hundreds of Nigerian soldiers retreated from Boko Haram into Cameroon, where they were disarmed. How strong of a grip does Boko Haram have on northern Nigeria? If Ebola manages to spread throughout the country, how much worse would such terroristic groups cause their outbreak to be?

kustomkarkommando
Oct 22, 2012

tentative8e8op posted:

I heard over the radio hundreds of Nigerian soldiers retreated from Boko Haram into Cameroon, where they were disarmed. How strong of a grip does Boko Haram have on northern Nigeria? If Ebola manages to spread throughout the country, how much worse would such terroristic groups cause their outbreak to be?

The Nigerian army does not retreat!

Al Jazeera posted:

Nigeria's military dismissed the claims and said the troops were "charging through the borders in a tactical manoeuvre" when they found themselves on Cameroonian soil.

It said that the soldiers were on their way back to Nigeria after following protocol by handing over "their weapons in order to assure the friendly country that they were not on a hostile mission."

Boko Haram's grip on the north has become considerably more tenuous since the Nigerian government instituted a state of emergency and flooded the North with troops, their frankly brutal tactics have put Boko Haram on the back foot and has forced them to withdraw into the rather inhospitable Sambisa forest. The last year has seen them change their tactics and they now primarily rely on brutal smash and grab attacks; attacking isolated villages, stealing what isn't nailed down, killing anyone that's left and then pulling back to bush camps. The switch in tactics has made them considerably more difficult to deal with, cracks have begun to show in the Nigerian army with reports of mutinies and low morale beginning to dribble out (the Nigerian army generally keeps a pretty tight leash on any news coming out of the affected provinces).

The recent wave of attacks and switch back to trying to grab and hold villages/cities seems to have been prompted by Cameroon's decision to escalate their military operations against them on their side of the border, they have a handful of strongholds in the remote northern regions of Cameroon that are now being more actively targeted than they where in the past. The gains they've made in the last week are significant but are still well below the territory they used to hold back in 2010 or so, if they continue with their raiding tactics it will definitely frustrate any attempts to manage a potential outbreak if Ebola spreads that far north.

kustomkarkommando fucked around with this message at 20:14 on Aug 27, 2014

Randandal
Feb 26, 2009

kustomkarkommando posted:

The Nigerian army does not retreat!

This is not at all too depressing to be hilarious

Slaan
Mar 16, 2009



ASHERAH DEMANDS I FEAST, I VOTE FOR A FEAST OF FLESH
^ :unsmith:

WoodrowSkillson posted:

Just get the gently caress out.

I am, actually. My Peace Corps service ends next week as I've finished my 2 year contract. Doesn't mean I feel terrible about leaving Benin in the middle of this poo poo, though. My neighbours are wealthy enough be terrified of ebola (they have tv), and the problems caused by it; and several of my high school club members have asked me how to avoid ebola, what it is, etc. Leaving is making me sad. :(

Slaan fucked around with this message at 22:30 on Aug 27, 2014

WoodrowSkillson
Feb 24, 2005

*Gestures at 60 years of Lions history*

Slaan posted:

^ :unsmith:


I am, actually. My Peace Corps service ends next week as I've finished my 2 year contract. Doesn't mean I feel terrible about leaving Benin in the middle of this poo poo, though. My neighbours are wealthy enough be terrified of ebola (they have tv), and the problems caused by it; and several of my high school club members have asked me how to avoid ebola, what it is, etc. Leaving is making me sad. :(

I'm glad you are leaving. I hope you were able to spread some better information advice to your friends there and I hope they can avoid the worst of things. Ebola is so nasty, but if you can avoid close contact its possible to ride out an outbreak.

Sheng-Ji Yang
Mar 5, 2014


On Monday, Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, arrived in Liberia to assess the Ebola outbreak. The situation "is overwhelming," he said.

The outbreak "really is a crisis and is affecting most if not all the counties in Liberia already," he told NPR from Monrovia, the capital city and first stop on a three-country visit. "This is absolutely unprecedented."

The CDC, Frieden said, "is working flat out on this, but this is huge and needs a global response. ... They need a lot of help from the world."

He emphasized that the toll is "far larger than has been recorded, not because they are trying to hide anything but because they are really overwhelmed by these numbers." Beyond this, he said, the cases "are increasing at an extremely quick rate, and this is very alarming."

As bad as the Ebola situation is, Frieden warned that the worst is yet to come. "Unfortunately, we are definitely not at the peak. It's going to get worse before it gets better," he said. "The real question is how much worse will it get? How many more people will be infected and how much more risk to the world will there be?"

http://www.npr.org/blogs/goatsandsoda/2014/08/26/343436300/cdc-director-on-ebola-we-are-definitely-not-at-the-peak

Sheng-Ji Yang
Mar 5, 2014


Médecins Sans Frontières/Doctors Without Borders (MSF) is rapidly scaling up its operations in Liberia as the international response to the Ebola outbreak in West Africa continues to be chaotic and entirely inadequate.

In its first week, MSF’s newest Ebola management centre – also known as ELWA3 – in the capital Monrovia, is already at capacity with 120 patients, and a further expansion is underway.

Meanwhile, in the north of the country, patients continue to flow into the newly rehabilitated Ebola management centre in Foya.

Serious lack of international leadership and coordination

“It is simply unacceptable that, five months after the declaration of this Ebola outbreak, serious discussions are only starting now about international leadership and coordination ,” says Brice de le Vingne, MSF Director of Operations.

“Self-protection is occupying the entire focus of states that have the expertise and resources to make a dramatic difference in the affected countries. They can do more, so why don’t they?”

The outbreak is spreading rapidly in Monrovia, overwhelming the few medical facilities accepting Ebola patients.

Much of the city’s medical system has shut down over fears of the virus among staff members and patients, leaving many people with no healthcare at all, generating an emergency within the emergency.

“In the aftermath of an earthquake it would be unthinkable that there are so few places where women can safely deliver their babies, or where people can be treated for life-threatening conditions,” says Lindis Hurum, MSF emergency coordinator in Monrovia.

“This is not only an Ebola outbreak – it is a humanitarian emergency, and it needs a full-scale humanitarian response.”

The number of people seeking care at the newly constructed 120-bed centre in Monrovia, which opened on 17th August, is growing faster than the team can handle, both in terms of the number of beds and the capacity of the staff.

Patients are coming from nearly every district of the city. The staff are struggling to screen new arrivals, care for admitted patients, safely remove dead bodies and transport them to the crematorium.

http://www.msf.org.uk/article/liberia-msfs-new-ebola-centres-already-overwhelmed

My Imaginary GF
Jul 17, 2005

by R. Guyovich
http://nos.nl/artikel/691669-ebolapatienten-weggestuurd.html

Translation from here: http://www.flutrackers.com/forum/showthread.php?t=227003

"Ebola patients sent away"

Wednesday Aug 27 2014

"We have staff at the gate who do nothing but turn away people. This is not easy, because we don't know where they could go," said Karline Kleijer from MSF.

In West Africa, the Ebola epidemic is still spreading rapidly. To help patients MSF opened an emergency clinic last week in the Liberian capital Monrovia. After four days the clinic was full.

Currently there are about 200 patients in the clinic. According Kleijer that could have been more than 600 already if they had opened the doors. That can not be, because so many people infected with Ebola would be a danger to the employees of MSF.

Not administered
Because there are not enough emergency clinics and regular healthcare is not functioning most Ebola patients can not be administered. Therefore, the clinic expanded by another dozen beds. But even that is not enough. "We know that there are thousands of patients are walking in the street, infecting other people," says Kleijer.

According to her, there are not enough resources to detect the contacts of the patients. Thereforepeople who are also infected can not be identified . " The houses of patients must be decontaminated. It will not happen."

emotional
The work of the rescuers is heavy. It is very hot in the suits that they need and there is always the risk of getting infected with the virus.

Emotionally it is difficult, says Kleijer. "One of the worst moments is when people die when they arrive here. Often with family and then you get their grief too."

"But what I find the weirdest is that I talk with patients that I know they are dead a few days later."

Ashcans
Jan 2, 2006

Let's do the space-time warp again!

Sheng-ji Yang posted:

He emphasized that the toll is "far larger than has been recorded, not because they are trying to hide anything but because they are really overwhelmed by these numbers." Beyond this, he said, the cases "are increasing at an extremely quick rate, and this is very alarming."

As bad as the Ebola situation is, Frieden warned that the worst is yet to come. "Unfortunately, we are definitely not at the peak. It's going to get worse before it gets better," he said. "The real question is how much worse will it get? How many more people will be infected and how much more risk to the world will there be?"

http://www.npr.org/blogs/goatsandsoda/2014/08/26/343436300/cdc-director-on-ebola-we-are-definitely-not-at-the-peak

This is, very depressingly, reminding me of the situation in Rwanda during the genocide. It was public, it was televised, there was no secret about what was going on, but everyone was just sort of gawping at it mindlessly, unwilling to actually do anything substantive. In particular, this quote reminds me of Gaillard (who was with the Red Cross, one of the few groups that actually remained in the country:

quote:

I remember a couple of funny phone calls from BBC London who made the first call around the 20th of April asking me the same question, "What's your estimation of the number of people killed?" and I told them at least 250,000. One week later they called again and asked me, "What's your estimation today?" So I told them, "You can double it. Five hundred thousand people have been killed." One week later they made a last call about this very specific question … and I answered, "Listen, after half a million, sir, I stopped counting." This was broadcast … in the beginning of May. Everybody knew every day, live, what was happening in this country. You could follow that every day on TV, on radio.

My Imaginary GF
Jul 17, 2005

by R. Guyovich
Hate to double-post and cross-post, I've been keeping track of the sites I most frequently check and compiled a mini-resource guide. If you have any suggestions for things to add, please PM them to me.

First up, some sites worth keeping an eye on:

http://crofsblogs.typepad.com/h5n1/ - infectious disease doctor, aggregates outbreak news and has a comprehensive resource list

http://www.flutrackers.com/forum/forumdisplay.php?f=3136 - forum frequented by healthcare workers, no-bullshit nor speculation. Often has articles translated to English that wouldn't be found elsewhere

http://virologydownunder.blogspot.com.au/?m=1 - joint blog of four Australian medical professionals, very informative and well-sourced. Great at discussing the technical aspects in for a layman's understanding without compromising quality


https://www.redcross.org.nz/blog/from-the-field/nursing-in-ebola-country/ - Red Cross nurse in Kenema, Sierra Leone, a hot zone where WHO has recently withdrawn from. Fairly infrequently updated (I'd image she's quite occupied with other matters)

Media and Institutions:

Speaking of,
http://saharareporters.com - Some better quality West African reporting, based in Nigeria

Brown Moses isn't the only outfit with a wordpress:
https://gabonpress.wordpress.com - Gabon-based reporting, in French (Salut AEF!) and comprehensive when machine-translated to English by Google

http://www.newvision.co.ug - Daily print paper in Uganda; while this West African Ebolavirus Zaire-strain outbreak hasn't spread to Uganda yet, Uganda has experienced and successfully contained several Ebola outbreaks since Ebola's first modern documentation in DRC '76. Also, I'm occassionally published there


Some interesting twitters to follow:

https://mobile.twitter.com/frankietaggart - reporter on the ground in Sierra Leone

https://mobile.twitter.com/HaertlG - WHO's social media guy

https://mobile.twitter.com/MSF - Official twitter account of Medicine Sans Frontiere/Doctors Without Borders, who need no introduction

https://mobile.twitter.com/UmaruFofana - Average Leonese female national (well, as average a Leonese twitter user as any) detailing her experiences on the ground in Sierra Leone.

https://mobile.twitter.com/aetiology - Associate Professor of Zoonotic Infectious Disease at Kent State University, all-around level-headed and informed tweeter. Often gets requests from journalists for interviews/has conversations with journos on the ground. Frequently tweeted back and forth with WHO during early stages of outbreak; I generally check out the twitter accounts of those whom are @'d with her to identify potential new resoures

Some speculation and country-specific resources:


Today's latest (dated the 24th of August) sitrep from the Liberian Ministry of Health, who have been taking this outbreak as seriously as it deserves to be:

http://reliefweb.int/sites/reliefweb.int/files/resources/Liberia%20Ebola%20SitRep%20101%20%20August%2024%202014.pdf

To note: 1,386 cases, 754 fatalities. Cumulative admission/isolation stands at 129. Case fatality rate among confirmed and probable: 57.6%, a number which likely underestimates the actual CFR.

Contacts listed: 3,509. Under follow-up: 1,897. Contacted on 24th: 1,515. Completed 21 days: 16. Worse, there's a growing backlog of case investigation forms from the field.

Specimens tested on 24 August: 0. Interesting to note, from the report it appears the National Reference Lab in Liberia conducted 16 tests on 24 August. That number is consistent with past testing in Liberia, and 16 tests/day appears to be the capacity in Liberia right now, down from the 19/day reported on 18th August. That means a capacity to test anywhere from 5 live individuals or 16 post-mortem tests. I think they've stopped collecting samples from live individuals. I'm not certain on this, though.

Also interesting to note from the report, no update on equipment stocks like PPE. It appears that only two counties are receiving new PPE and food supplies, the two in the west of Liberia with dedicated Ebola treatment centers.

Oh, JFK received transfer cases from West Point. It appears the worst fears for West Point are starting to come true.

Today's update from Nigeria: New case, previously undisclosed and unaccounted for. Diplomat met Sawyer in Lagos, went to a hotel in Port Loko, presumably died; his doctor treated him in secret and acquired Ebola, likely transmitted to others before death. So, uncontained outbreak in Nigeria right now.

http://saharareporters.com/2014/08/27/breaking-nigeria-records-new-ebola-death-port-harcourt#.U_5X64hNibA.twitter

This poo poo is what I've been harping upon in comparing Liberia's and Nigeria's official responses. Liberia quickly overcame its institutional denial; Nigeria is still in denial and a PR phase to prevent economic downtown.

Why does this matter? Nigeria has a GDP of >500 billion. Assuming an uncontained outbreak in Nigeria, I think the reported weekly GDP declines in Sierra Leone and Liberia can be used to estimate an economic decline of 4%-8% of current GDP value per week, at minimum. The most effective proxy to measure for this would be tarrif income and food prices. Worst-case, uncontrolled outbreak and tens, if not hundreds of billions in decline in the 2014 Nigerian GDP. Estimating GDP decline in epidemics is hard. I tend to use simple proxies to measure actual inflation as felt by the middle class, upper class, and expatriates, such as airfare from Lagos to Jburg, Brussels, USA (ATL, JFK, and GWB) and Dubai for 1-month, 1-week and 2-day prebooking.



Finally, would anyone be interested in a dedicated Ebola Epidemic 2014 thread?

Ebola's kinda taken over the Sub-Saharan Africa thread, and theres much more to discuss...like Chinese investment in Zim, or Mugabe's wife's power-play (from what I've heard, the generals were waiting for Mugabe's death to oust his family from power and transition to a semi-parliamentary system; operative word: Semi.), or the fact that for the first time more elephants are dying than being.

treasured8elief
Jul 25, 2011

Salad Prong

My Imaginary GF posted:

:words:


Finally, would anyone be interested in a dedicated Ebola Epidemic 2014 thread?

Amazing resource links, thank you

I think a dedicated epidemic thread is a good idea, as everything only looks to get ever so much worse, especially so if Nigeria has a large scale uncontained outbreak. India is having nearly 120 citizens, some of whom are suspected of being exposed to the virus, return from Liberia. They are being quarantined in Mumbai and Delhi.

Sheng-Ji Yang
Mar 5, 2014


https://www.youtube.com/watch?v=dzWel8JQD3A

My Imaginary GF
Jul 17, 2005

by R. Guyovich

tentative8e8op posted:

Amazing resource links, thank you

I think a dedicated epidemic thread is a good idea, as everything only looks to get ever so much worse, especially so if Nigeria has a large scale uncontained outbreak. India is having nearly 120 citizens, some of whom are suspected of being exposed to the virus, return from Liberia. They are being quarantined in Mumbai and Delhi.

No problem. I've got write-ups on DRC and Nigeria finished so far. I'm looking for volunteers willing to do write-ups on Sierra Leone, Liberia, and Guinea-Bisseau which cover the following:

Primer on the country's history
Economics
Politics
Ethnicities
Ebola in _Countryname_

Any takers?

Charlz Guybon
Nov 16, 2010

tentative8e8op posted:

Amazing resource links, thank you

I think a dedicated epidemic thread is a good idea, as everything only looks to get ever so much worse, especially so if Nigeria has a large scale uncontained outbreak. India is having nearly 120 citizens, some of whom are suspected of being exposed to the virus, return from Liberia. They are being quarantined in Mumbai and Delhi.
I have to agree. We absolutely need a thread dedicated to the epidemic.

Sheng-Ji Yang
Mar 5, 2014


My Imaginary GF posted:

No problem. I've got write-ups on DRC and Nigeria finished so far. I'm looking for volunteers willing to do write-ups on Sierra Leone, Liberia, and Guinea-Bisseau which cover the following:

Primer on the country's history
Economics
Politics
Ethnicities
Ebola in _Countryname_

Any takers?

That seems a lot more in-depth than is really necessary for a thread on a specific epidemic.

ukle
Nov 28, 2005

Sheng-ji Yang posted:

That seems a lot more in-depth than is really necessary for a thread on a specific epidemic.

Given the amount of Americans who will be reading the thread it will probably be a very good idea, as many of them would never of even have heard of e.g. Liberia and know of all its issues due to its recent history, lack of education and economics. Just one or 2 lines covering each bit should cover it I would of thought, with links to where to find more info.

Can I say that the only way a separate Ebola thread will work is if its made clear to limit speculation as much as possible, as trying to find real info on this is difficult as it is, especially when most of the countries in the region have lied at some point about cases or its severity.

My Imaginary GF
Jul 17, 2005

by R. Guyovich

ukle posted:

Given the amount of Americans who will be reading the thread it will probably be a very good idea, as many of them would never of even have heard of e.g. Liberia and know of all its issues due to its recent history, lack of education and economics. Just one or 2 lines covering each bit should cover it I would of thought, with links to where to find more info.

Can I say that the only way a separate Ebola thread will work is if its made clear to limit speculation as much as possible, as trying to find real info on this is difficult as it is, especially when most of the countries in the region have lied at some point about cases or its severity.

Pretty much what I was thinking. No-bullshit, less speculative thread to post about the outbreak with basic background info on the development status of outbreak areas, the factors which are fueling this epidemic, and past experience with/the progression of this Ebola epidemic. I wrote up Congo due to having some investigative epidemiological sources on hand to cite, and Nigeria due to personal connection and knowledge of its...unique position in the world.

Sheng-Ji Yang
Mar 5, 2014


http://www.who.int/csr/don/2014_08_28_ebola/en/

WHO just updates the numbers as of the 26th:

As of 26 August 2014, the cumulative number of cases attributed to EVD in the four countries stands at 3 069, including 1552 deaths. The distribution and classification of the cases are as follows: Guinea, 647 cases (482 confirmed, 141 probable, and 25 suspected), including 430 deaths; Liberia, 1378 cases (322 confirmed, 674 probable, and 382 suspected), including 694 deaths; Nigeria, 17 cases (13 confirmed, 1 probable, and 3 suspected), including 6 deaths; and Sierra Leone, 1026 cases (935 confirmed, 37 probable, and 54 suspected), including 422 deaths.

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Torka
Jan 5, 2008

If you get it and then recover, can you get it again or are you immune after that?

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