Tuesday, April 2, 2019

Ebola: I hate having to say "I told you so!", but...


In November last year, I wrote about the Ebola crisis in Congo:

... it's not surprising to me at all that this Ebola outbreak is spreading dangerously far and fast.  I see no way whatsoever that it can be controlled, and I think efforts to quarantine the area, to stop it spreading, are pointless.  They take no account of the reality on the ground.

A month later, I said this:

I've written before about the risks involvedA million people are now in Ebola's melting-pot.  Already some will have fled into the bush, and will be making their way across inter-tribal boundaries and international borders.  Based on my knowledge of the area and its people, I no longer think this outbreak can be contained.  I hope the authorities are checking air travelers very, very rigorously, because if just a few get on planes to Europe and the Far East while carrying Ebola . . . hell's coming to breakfast.

I hate being proved right about something so dangerous.  From a news report this morning:

Democratic Republic of Congo’s Ebola outbreak is spreading at its fastest rate yet, eight months after it was first detected, the World Health Organization (WHO) said on Monday.

Each of the past two weeks has registered a record number of new cases, marking a sharp setback for efforts to respond to the second biggest outbreak ever, as militia violence and community resistance have impeded access to affected areas.

Less than three weeks ago, the WHO said the outbreak of the hemorrhagic fever was largely contained and could be stopped by September, noting that weekly case numbers had halved from earlier in the year to about 25.

But the number of cases hit a record 57 the following week, and then jumped to 72 last week, said WHO spokesman Christian Lindmeier. Previous spikes of around 50 cases per week were documented in late January and mid-November.

More alarmingly, more than half of the Ebola deaths last week occurred outside of treatment centers, according to Congo health ministry data, meaning there is a much greater chance they transmitted the virus to those around them.

“People are becoming infected without access to response measures,” Lindmeier told Reuters.

There's more at the link.  Bold, underlined text is my emphasis.

The authorities in western Congo are running out of resources, running out of aid workers, and running out of time.  If this epidemic busts loose from its current geographic confines, it'll spread throughout Central Africa, all the way to the Indian Ocean;  and wealthier refugees fleeing its spread will probably carry it via airline routes to Europe, the Far East and North America before sufficient measures can be put in place to stop them.  The current form of the virus appears to have an incubation period of up to 21 days before visible symptoms appear.  During that incubation period, the patient is already infectious - they just don't know it yet.  Authorities looking for signs of infection - typically fever, etc. - won't find any;  and in the absence of mandatory, universal quarantine, plus blood testing, for everyone entering a country from the affected areas (which is impossible in practical terms), the infection will get through.

It will take less than a dozen full-blown cases of Ebola to overwhelm the average US city's medical system, which is utterly incapable of providing the large-scale isolation care required to treat this disease.

Friends, watch this situation very, very carefully.  I've lived in that part of the world.  Ebola is simply a more recent, more virulent strain of West African hemorrhagic fever, known in other forms as Lassa fever, the Marburg virus, etc.  I've had Lassa fever, and even that milder, attenuated strain damn nearly killed me.  Ebola is currently killing at least two out of every three people who contract it;  some claim the death toll is as high as 80-90%, depending on location and who's measuring.  Those who survive it are all too often left with a deep, long-lasting reservoir of the disease.  They might contract the disease again, or pass it on to anyone with whom they share body fluids, even after recovering from the initial bout.

I've already had several readers ask me what practical precautions and preparations they can make, in case Ebola gets loose over here.  Frankly, there's not much we, as individuals, can do to stop this mess.  However, I urge you to keep a supply of procedure masks on hand (I use this brand), as well as abundant antiseptic/disinfectant hand cleaner (I prefer a hospital-grade solution like Hibiclens);  a supply of nitrile gloves in your and your family's sizes (thicker, heavier-duty material is preferable, to avoid rips or tears that might expose you to infection - I prefer at least 3 mil, and if possible 5 mil);  and sufficient food, water and household necessities in reserve to be able to minimize trips to the store or any other public place.  Don't wait to buy those things until Ebola is already spreading in this country.  Right now, they're freely available and inexpensive.  Both conditions will change very quickly if Ebola gets to be more of a threat.

Peter

5 comments:

Aesop said...

Not quite so much.

1) This is only moving fast for the DRC.
Compared to 2014 in West Africa, this epidemic is moving glacially.
Mainly, because unlike 2014, there is an effective experimental vaccine.
But this outbreak hasn't even reached exponential growth, unlike 2014, and it's still barely 1000 cases.
In other words, half the pure exponential growth seen in 2014.

2) The potential is still there.
We're talking about pre-literate anti-science tribal cement-heads.
They burn down the treatment centers, and steal the infected corpses back to do traditional funerals, where they fondle the festering carcasses. After eating rodentiiae from the bush that harbored the virus in the first place, and then undercooking them.
These are not humanity's brightest lightbulbs.

3) Most of them cannot cobble up bus fare to the next village, let alone air fare out of Africa.
Thank a merciful heaven.

That's on the plus side.

On the minus side:

1) The numbers we have are based on WHO and DRC self-reporting.
There is no reporting from multiple regions where they've burned the ETCs and chased out the survey teams. So it may be far worse. (The fudge factor in 2014 West Africa was 300%, minimum. I.e., if they report 100 casualties, there were at least 300.)

2) The "screening" at airports is kabuki theatre. This strain shows no fevers - the only sign checked at the airports - in 50% of confirmed cases.
IOW, this one will escape the jungle eventually, to a metaphysical certainty, five minutes after it gets to a city with an international airport.

3)Exactly as noted, there is no cure for Ebola, and contraction is a lifelong torture sentence, including repeated positive titer of live virus every time they check, at every known post-infection marker date: 1 month, 6 months, 1 year, 2 years, 3 years, etc. Like Chicken pox, it never goes away, it just becomes dormant. Until it doesn't.

4) A dozen cases won't overwhelm a city's resources: 12 cases in the US will overwhelm North America's resources.
There are only 11 BL-IV beds in all of the U.S., and none in Canada nor Mexico. Case #12 goes to outside hospitals.
(FTR, we had 10 cases under treatment in the US in 2014. That's how close we came to disaster: two more patients.)
How bad is that?
One case - with the best CDC guidelines - overwhelmed all of Dallas' ability to cope, and took down a 973-bed major regional hospital for six months.
One. Case.

5) Absolutely nothing has been done from 2014 to now to better prepare any American hospital for Ebola. Neither in general, nor specifically. If anything, we're worse off.

6) The way to personally cope with Ebola isn't masks and gloves. That's too little, too late.
It's concertina wire and buckshot.
Followed by gasoline and road flares for the slow learners.
You aren't going to "save" nor "treat" a family member who gets it. They're effectively dead.

In Africa, Ebola Treatment Centers provide "palliative care".
Not IVs. Not medicine. Just cool cloths, cleaning up their vomit and diarrhea, and zipping them lovingly into body bags when they die.
Provided mainly by the 10-20% who manage to survive the disease, and have nothing better to do afterwards. Because as noted, they're still riddled with virus afterwards, in breast milk, sweat, semen, other secretions, etc. For God Alone knows how long afterwards.

Trying to treat even one person overwhelmed a major hospital.
You aren't going to do it with less than a staff of 50, and a warehouse full of gear, plus a crater-sized burn pit for waste products.

IOW, once it gets near you, you either self-quarantine inside a clean zone, or you don't.
There will be no going back and forth.
And bringing someone infected inside your clean zone will just make it a death zone, and kill your entire clan.

Welcome to Italy in the 1300s, when Plague arrives.

The Lab Manager said...

Hell, thanks to the flooding in the MidWest, we may not need any help from the Ebola virus:

https://www.lewrockwell.com/2019/04/james-howard-kunstler/biblical-anxieties/

A shy, science-nerd correspondent writes: “Epidemiologists speculate that a flooding event in Central Asia steppes triggered the 1347 Eurasian plague outbreak. Rumors of a mass human die-off in India reached Europe in the mid-1340’s. The Mongols besieging the coastal city of Trebizond on the shore of the Black Sea catapulted plague infested corpses over the city walls and Italian merchant ships fleeing Trebizond carried the infestation to Genoa which foolishly permitted the dying crew to land…. Rodents hosting plague spreading fleas typically inhabit arid grassland regions such as the Great Plains of America and the semi deserts of California and New Mexico. The current flooding of the American Mid-West and the mass dumping of flood tainted wheat, corn and soybeans will likely spark a rodent population explosion in the region, which in the context of rat-swarming homeless encampments may yield a 1347 repeat event in North America during the 2020s. What happened before can happen again.”

Richard said...

Over a million to flood over the border this year. Touch screens spreading disease. Ebola.

Why do I not have warm fuzzies?

Antibubba said...

You had Lassa fever? That must be quite a story.

Peter said...

@Antibubba: Not really. It's endemic in West Africa. Lots of people have had it. A bad case will kill you, sure, but overall, mortality isn't nearly as bad as Ebola or Marburg.