My Imaginary GF posted:

poo poo's real bad

axeil posted:

I hadn't even realized how bad things had gotten there. It sounds like the best case scenario is serious instability and possible revolution, the middle case is massive social upheaval and lots of starvation and the worst case scenario is "West Africa becomes a wasteland due to society collapsing."

As if Africa didn't have enough problems to deal with

Johnny Cache Hit posted:

WHO is forecasting Monrovia needs an additional 800 beds in isolation wards for treating patients. That's almost triple the current number in the entire country.

It's a nightmare.

ChairMaster posted:

So just wondering, the only ways to stop or even slow down the Ebola outbreak in these countries are by having a proper hardass quarantine where the soldiers shoot anyone who tries to leave, having an adequate number of doctors and hospital space, and somehow teaching millions and millions of people living in some of the most hosed up countries on the planet how germ theory works. Is there like a fourth thing that could help?

Spazzle posted:

A vaccine.

quote:

A four-day nationwide lockdown announced by the Sierra Leone government in a bid to contain the biggest ever outbreak of Ebola could instead exacerbate the spread of the disease, aid agencies have warned.

From 18 to 21 September people across the west African nation will not be allowed to leave their homes, a senior official in the president's office said on Friday.

But Médecins sans Frontières (MSF) raised concern about the drastic step, warning that it could lead people to try to conceal infections from the authorities.

A spokeswoman said: "It has been our experience that lockdowns and quarantines do not help control Ebola as they end up driving people underground and jeopardising the trust between people and health providers. This leads to the concealment of potential cases and ends up spreading the disease further."

My Imaginary GF posted:

Just a reminder: 80 beds requires 230 support staff; 2,300 support staff for Monrovia. 800:2,300 isn't a sustainable case management load if it goes an order or two higher. 8,000:23,000, or in two to six months, 80,000:230,000. Sierra Leone issued a call for 23,000~ employes recently, with salary paid at Western rates. About $500/day (USD) for staff [including the 1/10 HCW contracting EBV and the $25,000 life insurance offered with an estimated CFR of 70%, could use an estimated rate for contact tracer infections and burial team infections], 500*23,000 = $11,500,000 daily direct (KPMG monitoring) salary costs in Sierra Leone for the next 6 months with the staffing levels required for September, or, $2,070,000,000 salary cost for the ebolavirus outbreak in Sierra Leone paid for by WHO. Does not include any costs other than wages and benefits paid directly to Leonese employes and monitored by KPMG, so I expect the salaries and insurance to actually go through.

E: Note, this is a full quarter of Sierra Leone's yearly GDP.

I'm on my mobile and don't have a good way to do it, if anyone has the time to go through: http://health.gov.sl/?page_id=583

Sierra Leone's daily situation reports and graph out the contact tracing (new listed/new illness/total contacts/completed 21 days) I think it'd make for a pretty easy visual on the growing rate of the crisis.

quote:

New Listed New Cases Contacts Completed 21 Days
8/28-9/3 295 193 1305 905
8/21-8/27 276 172 1158 588
8/14-8/20 234 61 820 684
8/8-8/13 215 50 700 600

Pillowpants posted:

Pillowpants posted:

Do you want me to continue to take the data down as this goes on?

Pillowpants posted:

Do you want me to continue to take the data down as this goes on?

My Imaginary GF posted:

Erhiopia

sofokles posted:

You have several times stated that Ethiopia would be a most likely next spread step from an outbreak in Nigeria. Would you care to elaborate on that as I find that intriguing given the distance between the countries.

Evilreaver posted:

Yes! Yes please, charts and graphs are the best, and you may well be the only one actually keeping score.

An email from WHO posted:

Situation in Liberia: non-conventional interventions needed

8 September 2014

During the past weeks, a WHO team of emergency experts worked together with President Ellen Johnson Sirleaf and members of her government to assess the Ebola situation in Liberia.

Transmission of the Ebola virus in Liberia is already intense and the number of new cases is increasing exponentially.

The investigative team worked alongside staff from the Ministry of Health, local health officials, and other key partners working in the country.

All agreed that the demands of the Ebola outbreak have completely outstripped the government’s and partners’ capacity to respond.

Fourteen of Liberia’s 15 counties have now reported confirmed cases.

Some 152 health care workers have been infected and 79 have died. When the outbreak began, Liberia had only one doctor to treat nearly 100,000 people in a total population of 4.4 million people. Every infection or death of a doctor or nurse depletes response capacity significantly.

Liberia, together with the other hard-hit countries, namely Guinea and Sierra Leone, is experiencing a phenomenon never before seen in any previous Ebola outbreak. As soon as a new Ebola treatment facility is opened, it immediately fills to overflowing with patients, pointing to a large but previously invisible caseload.

Of all Ebola-affected countries, Liberia has the highest cumulative number of reported cases and deaths, amounting, on 8 September, to nearly two thousand cases and more than one thousand deaths. The case-fatality rate, at 58%, is also among the highest.

Situation in Montserrado county

The WHO investigation concentrated on Montserrado county, which includes Liberia’s capital, Monrovia. The county is home to more than one million people. The teeming West Point slum, which has no sanitation, little running water, and virtually no electrical supplies, is also located in Monrovia, and is adjacent to the city’s major market district.

In Montserrado county, the team estimated that 1000 beds are urgently needed for the treatment of currently infected Ebola patients. At present only 240 beds are available, with an additional 260 beds either planned or in the process of being put in place. These estimates mean that only half of the urgent and immediate capacity needs could be met within the next few weeks and months.

The number of new cases is moving far faster than the capacity to manage them in Ebola-specific treatment centres.

For example, an Ebola treatment facility, hastily improvised by WHO for the Ministry of Health, was recently set up to manage 30 patients but had more than 70 patients as soon as it opened.

WHO estimates that 200 to 250 medical staff are needed to safely manage an Ebola treatment facility with 70 beds.

The investigation team viewed conditions in general-purpose health facilities as well as Ebola-specific transit and treatment facilities.

The John F Kennedy Medical Center in Monrovia, which was largely destroyed during Liberia’s civil war, remains the country’s only academic referral hospital. The hospital is plagued by electrical fires and floods, and several medical staff were infected there and died, depleting the hospital’s limited workforce further.

The fact that early symptoms of Ebola virus disease mimic those of many other common infectious diseases increases the likelihood that Ebola patients will be treated in the same ward as patients suffering from other infections, putting cases and medical staff alike at very high risk of exposure.

In Monrovia, taxis filled with entire families, of whom some members are thought to be infected with the Ebola virus, crisscross the city, searching for a treatment bed. There are none. As WHO staff in Liberia confirm, no free beds for Ebola treatment exist anywhere in the country.

According to a WHO staff member who has been in Liberia for the past several weeks, motorbike-taxis and regular taxis are a hot source of potential Ebola virus transmission, as these vehicles are not disinfected at all, much less before new passengers are taken on board.

When patients are turned away at Ebola treatment centres, they have no choice but to return to their communities and homes, where they inevitably infect others, perpetuating constantly higher flare-ups in the number of cases.

Other urgent needs include finding shelters for orphans and helping recovered patients who have been rejected by their families or neighbours.

Last week, WHO sent one of its most experienced emergency managers to head the WHO office in Monrovia. Coordination among key partners is rapidly improving, aiming for a better match between resources and rapidly escalating needs.

Implications of the investigation

The investigation in Liberia yields three important conclusions that need to shape the Ebola response in high-transmission countries.

First, conventional Ebola control interventions are not having an adequate impact in Liberia, though they appear to be working elsewhere in areas of limited transmission, most notably in Nigeria, Senegal, and the Democratic Republic of Congo.

Second, far greater community engagement is the cornerstone of a more effective response. Where communities take charge, especially in rural areas, and put in place their own solutions and protective measures, Ebola transmission has slowed considerably.

Third, key development partners who are supporting the response in Liberia and elsewhere need to prepare to scale up their current efforts by three- to four-fold.

As WHO Director-General Dr Margaret Chan told agencies and officials last week in New York City and Washington, DC, development partners need to prepare for an “exponential increase” in Ebola cases in countries currently experiencing intense virus transmission.

Many thousands of new cases are expected in Liberia over the coming three weeks.

WHO and its Director-General will continue to advocate for more Ebola treatment beds in Liberia and elsewhere, and will hold the world accountable for responding to this dire emergency with its unprecedented dimensions of human suffering.

quote:

Second, far greater community engagement is the cornerstone of a more effective response. Where communities take charge, especially in rural areas, and put in place their own solutions and protective measures, Ebola transmission has slowed considerably.

Pillowpants posted:

Is there a good place to find a list of the Liberia sitreps so I can do what I am doing with Sierra Leone?

ukle posted:

MSF's call to send in Military assets.

quote:

According to the Oxford model, in addition to the seven countries who have reported Ebola outbreaks in this epidemic and in past outbreaks since the disease was identified 1976, 15 other countries are at risk. There are five known strains of Ebola, and the one currently causing the West African outbreak, Zaire, is the most virulent. The other strains, Sudan, Taï Forest and Bundibugyo, have caused contained outbreaks in Ivory Coast, Sudan, and Uganda in the past. And the Reston species has not caused any known outbreaks, according to the World Health Organization.

According to the Oxford prediction, these countries are at risk of animal-to-human transmission of Ebola by virtue of their geography: Nigeria, Cameroon, Central African Republic, Ghana, Liberia, Sierra Leone, Angola, Togo, United Republic of Tanzania, Ethiopia, Mozambique, Burundi, Equatorial Guinea, Madagascar and Malawi.

Xandu posted:

This is an interesting point


It's pretty clear that even with foreign groups coming in, at the current growth rate of infections, Liberia will never have enough hospital beds, let alone nurses and doctors, to treat all the cases. Training local community groups to handle quarantining and tracing of cases would be a huge help.

Ebola Roulette posted:

http://www.washingtonpost.com/news/to-your-health/wp/2014/09/09/oxford-study-predicts-15-more-countries-are-at-risk-of-ebola-exposure/

School Nickname posted:

Would dogs be in that animal list?

Ebola Roulette posted:

http://www.washingtonpost.com/news/to-your-health/wp/2014/09/09/oxford-study-predicts-15-more-countries-are-at-risk-of-ebola-exposure/

Slaan posted:

You bénin isn't on that list

Peven Stan posted:

Ebola evacuations to US greater than previously known

Peven Stan posted:

Ebola evacuations to US greater than previously known

Torpor posted:

I really don't think this type of thing is necessarily such a great idea. US Hospitals are not good at stopping contagious pathogens.

Nintendo Kid posted:

Yes they are.

Torpor posted:

I really don't think this type of thing is necessarily such a great idea. US Hospitals are not good at stopping contagious pathogens.

My Imaginary GF posted:

No about it. One of the biggest sticking points in recruiting trained volunteers to go to the hotzone is an implicit guarantee of medevac if any symptoms develop or if exposure is known. I can PM you some interesting State cables on the subject if you have plat?